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Safety, immediate and mid-term results of the newer generation of hydrogel coils in the treatment of ruptured aneurysms: a multicenter study
  1. Guilherme Dabus1,
  2. Lotfi Hacein-Bey2,
  3. Bahram Varjavand2,
  4. R Dana Tomalty3,
  5. Patrick P Han4,
  6. Vadim Yerokhin4,
  7. Italo Linfante1,
  8. J Mocco5,
  9. Thomas Oxley5,
  10. Alejandro Spiotta6,
  11. M Imran Chaudry6,
  12. Raymond D Turner6,
  13. Aquilla S Turk6
  1. 1Miami Cardiac & Vascular Institute and Baptist Neuroscience Center, Miami, Florida, USA
  2. 2Sutter Health, Sacramento, California, USA
  3. 3Radiology of Huntsville, Huntsville, Alabama, USA
  4. 4St John Neuroscience Institute, Tulsa, Oklahoma, USA
  5. 5Mount Sinai Hospital, New York, New York, USA
  6. 6Medical University of South Carolina, Charleston, South Carolina, USA
  1. Correspondence to Dr Guilherme Dabus, Miami Cardiac & Vascular Institute, 8900 N Kendall Drive, Miami, FL 33176, USA; gdabus{at}gmail.com

Abstract

Objective To assess the ‘real-world’ performance of the newer generation of hydrogel coils in ruptured aneurysms.

Methods A multicenter retrospective study was carried out of angiographic and clinical outcome data on consecutive patients with ruptured aneurysms treated with at least 70% of the newer generation of hydrogel coils. Demographics and data on clinical grade, smoking, use of statins, aneurysm size, location, technique used, packing density, immediate angiographic result, angiographic follow-up, rebleeding and clinical outcome were obtained and analyzed.

Results Eighty patients (54F; 26M) with an average age of 55.1 years were entered in the study. Forty-four presented good clinical grade (Hunt and Hess 1 or 2). Forty-two (52.5%) aneurysms were ≤5 mm. 56.7% of the aneurysms were treated with simple coil embolization and 39.6% with balloon-assisted coil. The packing density ranged from 9.3% to 92.6% (mean 48.5%). Immediate occlusion rates (Raymond–Roy Scale) were: complete occlusion (class I) in 57.5%, residual neck (class II) in 32.5% and residual aneurysm (class III) in 10%. Intraoperative rupture occurred in 3 cases (3.75%). Clinical follow-up, available in 73 patients, showed a good outcome (modified Rankin Scale 0–2) in 76.3%. Preliminary data on imaging follow-up were available in 54 patients (average 6.8 months) with complete occlusion in 77.8%, residual neck in 20.3% and residual aneurysm in 1.9%. There was no re-hemorrhage.

Conclusions Our data show that the use of the newer-generation hydrogel coils in the treatment of ruptured aneurysms is feasible, safe and effective with high immediate and mid-term occlusion rates and low morbidity.

  • Aneurysm
  • Subarachnoid
  • Hemorrhage
  • Embolic

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Footnotes

  • Contributors Conception: GD, LH-B, RDT, PPH, JM and AST; acquisition and interpretation of the data: GD, LH-B, BV, RDT, PPH, VY, IL, JM, TO, AS, MIC, RDT and AST; drafting: GD; revising: GD, LH-B, RDT, PPH, JM and AST; final approval: GD, LH-B, BV, RDT, PPH, VY, IL, JM, TO, AS, MIC, RDT and AST.

  • Competing interests GD, RDT, LH-B, BV, PPH, AS, MIC, RDT and AST are consultants for MicroVention. JM is co-principal investigator for COAST. AS, MIC, RDT and AST also received research funding from MicroVention.

  • Ethics approval Institutional review board.

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

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