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Embolization of intracranial aneurysms with second-generation Matrix-2 detachable coils: mid-term and long-term results
  1. Sameer A Ansari1,
  2. Eric J Dueweke2,
  3. Yassine Kanaan2,
  4. Neeraj Chaudhary2,
  5. Dheeraj Gandhi3,
  6. B Gregory Thompson3,
  7. Joseph J Gemmete2
  1. 1Department of Radiology, Neurology, and Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  2. 2Department of Radiology and Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, USA
  3. 3Department of Radiology and Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
  1. Correspondence to Sameer A Ansari, MD, PhD, Neurointerventional Surgery, Departments of Radiology, Neurology, and Neurosurgery, Northwestern University Feinberg School of Medicine, 676 N. St Clair Street, Suite 800, Chicago, IL 60611-2927, USA; s-ansari{at}northwestern.edu

Abstract

Background Bioactive polyglycolic/polylactic acid (PGLA)-coated Matrix detachable coils were reported to incite intra-aneurysmal inflammation and fibrosis. Multiple large case series with Matrix-1 coils have shown no advantage with respect to aneurysm recurrence. Second-generation Matrix-2 coils were designed with improved platinum support and reduced copolymer friction. We assessed the safety and efficacy of Matrix-2 coil embolization.

Methods 84 aneurysms were embolized primarily with Matrix-2 coils. Anatomic results were evaluated using a modified Raymond scale with progressive occlusion or recanalization/recurrence strictly defined as any interval change in intra-aneurysmal opacification.

Results Mid-term (8.9±3.4 months) and long-term (23.0±7.4 months) follow-up was available for 65 aneurysms. At mid-term, 55 (85%) aneurysms remained stable (or progressed to occlusion) versus 10 (15%) recurrent aneurysms, 7 (11%) requiring retreatment. At long term, 49 (75%) aneurysms remained stable versus 16 (25%) recurrent aneurysms, 12 (18%) requiring retreatment. Statistically significant factors affecting recanalization included ruptured aneurysms 9/20 (45%), large aneurysms 5/8 (71%), post-procedure residual aneurysms 6/12 (50%) and differential coil packing density of recurrent (21%) versus stable (28%) aneurysms. Patient morbidity (5%) was limited to thromboembolic complications (n=4) or aneurysm rerupture (n=1). Patient mortality (5%) was secondary to subarachnoid hemorrhage complications (n=4) with no procedure-related deaths (0%).

Conclusion Coil embolization with Matrix-2 coils is safe and effective, preventing recanalization in small aneurysms at mid-term. Although these aneurysm recurrence rates initially appeared lower than previous reports with Matrix-1 or platinum coils, significant late recanalization was observed on long-term follow-up. We postulate that any derived benefit from Matrix-2 coils is directly dependent on post-procedure outcomes and coil packing density.

  • Aneurysm
  • brain
  • coil
  • coil embolization
  • intervention
  • intracranial aneurysm
  • Matrix
  • PGLA
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Footnotes

  • Competing interests None to declare.

  • Ethics approval This study was conducted with the approval of the Institutional Review Board, University of Michigan, Ann Arbor, Michigan, USA.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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