TY - JOUR T1 - Five-year results of randomized bioactive versus bare metal coils in the treatment of intracranial aneurysms: the Matrix and Platinum Science (MAPS) Trial JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 930 LP - 934 DO - 10.1136/neurintsurg-2020-016906 VL - 13 IS - 10 AU - Cameron G McDougall AU - S Claiborne Johnston AU - Steven W Hetts AU - Anil Gholkar AU - Stanley L Barnwell AU - Juan Carlos Vazquez Suarez AU - Javier Massó Romero AU - John C Chaloupka AU - Alain Bonafe AU - Ajay K Wakhloo AU - Donatella Tampieri AU - Christopher F Dowd AU - Allan J Fox AU - Aquilla S Turk A2 - , Y1 - 2021/10/01 UR - http://jnis.bmj.com/content/13/10/930.abstract N2 - Background No randomized trial of intracranial aneurysm coiling has compared long-term efficacy of polymer-modified coils to bare metal coils (BMCs). We report 5-year results comparing Matrix2 coils to BMCs. The primary objective was to compare the rates of target aneurysm recurrence (TAR) at 12 months. Secondary objectives included angiographic outcomes at TAR or 12 months and TAR at 5 years.Methods A total of 626 patients were randomized to BMCs or Matrix2 coils. Detailed methods and 1-year results have been published previously.Results Of 580 patients eligible for 5-year follow-up, 431 (74.3%) completed follow-up or reached TAR. Matrix2 coils were non-inferior to BMCs (P=0.8) but did not confer any benefit. Core lab reported post-treatment residual aneurysm filling (Raymond III) correlated with TAR (P<0.0001) and with aneurysm hemorrhage after treatment (P<0.008). Repeat aneurysmal hemorrhage after treatment, but before hospital discharge, occurred in three patients treated for acutely ruptured aneurysms. Additionally, two patients treated for unruptured aneurysms experienced a first hemorrhage during follow-up. All five hemorrhages resulted from aneurysms with Raymond III residual aneurysm filling persisting after initial treatment. After 5 years follow-up, 2/626 (0.3%) patients are known to have had target aneurysm rupture following hospital discharge. The annualized rate of delayed hemorrhage after coiling was 2/398/5=0.001 (0.1%) per year for unruptured aneurysms and 0 for ruptured aneurysms.Conclusions After 5 years Matrix2 coils were non-inferior to BMCs but no benefit was demonstrated. Post-treatment residual angiographic aneurysm filling (Raymond III) is strongly associated with TAR (P<0.0001) and post-treatment aneurysmal hemorrhage (P=0.008).Data are available upon reasonable request. All datasets are available upon reasonable request. These data are maintained by Stryker Neurovascular. Patricia Morgan, BSN, RN, Medical Science Liaison, can be contacted at patricia.morgan@stryker.com regarding such inquiries. ER -