Objective We report our clinical experience in treating 34 aneurysms in 29 patients using the Penumbra PC400 Large Volume Coil.

Clinical presentation and treatment Our treatment population consisted of four large (10–25 mm) and 30 small (<10 mm) aneurysms. Nine were ruptured and 25 unruptured. Aneurysm location was 24 anterior circulation vs 10 posterior circulation. For the small aneurysms the average aneurysm size was 5.4 mm, average of 2.1 coils/aneurysm, and 48.9% average packing density. For the large aneurysms the average aneurysm size was 11.5 mm and 31.2% average packing density. An average of 5.6 coils were placed in three of the large aneurysms that were treated with only the PC400 coils. One of the large aneurysms had been previously treated with five GDC coils and then three Penumbra coils were used to treat recurrent aneurysm. Two patients had a stent placed across the aneurysm neck during a separate procedure performed prior to coiling and two patients had a stent placed during the coil procedure. One patient with a ruptured Left SCA aneurysm experienced a non-disabling Left PCA infarct giving a 2.9 % complication rate. Six month follow-up performed in 14 aneurysms.

Conclusion Our clinical experience with the PC400 Coil system has demonstrated this 0.020′ coil and 025 ID deployment catheter to be safe and efficacious in treating both small and large aneurysms. Using the PC400 Large Volume Coil results in a higher packing density while using fewer coils. The use of fewer coils has proven to reduce case time and procedural costs. Follow-up data suggest that the use of the coils produced durable occlusions. The softness by design of this large volume coil combined with the improved body of the deployment catheter has markedly improved the treatment of both large and small aneurysms.

Competing interests B Baxter: Stryker, ev3.