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E-037 Initial Multi-Centre Experience with the Penumbra PC 400 Detachable Coil in aneurysms 10 mm or greater
  1. I Chaudry1,
  2. D Frei2,
  3. B Baxter3,
  4. A Patel4,
  5. D Huddle2,
  6. D Loy2,
  7. H Moyle5,
  8. M Polykarpou4,
  9. A Patel6,
  10. R Turner7,
  11. A Turk8
  1. 1Medical University of South Carolina, Charleston, SC
  2. 2Swedish Medical Center, Englewood, CO
  3. 3Erlanger Medical Center, Chattanooga, TN
  4. 4Department of Neurosugery, Mt. Sinai Hospital, New York, NY
  5. 5Department of Neurosurgery, Mt. Sinai Hospital, New York, NY
  6. 6Mt. Sinai Hospital, New York, NY
  7. 7Department of Neurosurgery, Medical University of South Carolina, Charleston, SC
  8. 8Department of Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, SC

Abstract

Background Aneurysm coil technology has changed considerably since the introduction of the GDC coil. We evaluated our initial clinical experience with a novel 0.020 Penumbra PC 400 coil to determine device safety and acute performance.

Materials and Methods Between 2/2011 and 9/2012, 143 aneurysms were coiled with Penumbra PC 400 coils at four high volume centres. Of these, 40 aneurysms had a maximum diameter of 10 mm or greater. Average aneurysm size in this cohort was 13 mm with 20% of aneurysms being ophthalmic in location, 22% other ICA (cavernous, superior hypophyseal or dorsal wall), 17% in ACOM region, 12.5% PCOM, 15% Basilar, 7.5% vertebral and 5% in the MCA. 18% of the cases were treated with balloon assisted coiling, 33% were stent assisted coiling, and 3% utilised both balloons and stents. 30% of the cases achieved an initial Raymond Scale of 1, 25% achieved a Raymond scale of 2, and 45% were Raymond Scale of 3. Half (20) of this patient cohort have angiographic follow up at the time of this abstract. Based on the same/better/worse scale there is a strong trend towards improved angiographic outcomes at 6 months and one year. Eleven had improved, 6 remained unchanged and 2 worsened, none have required retreatment. We experienced a 5% clinically significant procedural complication rate, which include an aneurysm perforation in a 21 mm right dorsal wall ICA aneurysm that presented as a grade 4 Hunt and Hess SAH who expired and a temporal lobe infarct secondary to distal coil migration during treatment of an 18 mm paraophthalmic aneurysm in a grade 4 Hunt and Hess SAH patient that expired from SAH sequellae. We continue to use the coils and accrue follow up and will update results at time of the meeting.

Discussion The new Penumbra PC 400 coils are a unique 0.020 coil that appears to be safe and effective in treating large aneurysms.

Disclosures I. Chaudry: 2; C; Penumbra, Microvention, Covidien. D. Frei: None. B. Baxter: None. A. Patel: None. D. Huddle: None. D. Loy: None. H. Moyle: None. M. Polykarpou: None. A. Patel: None. R. Turner: None. A. Turk: 1; C; Penumbra.

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