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Endovascular treatment of 404 intracranial aneurysms treated with nexus detachable coils: short-term and mid-term results from a prospective, consecutive, European multicenter study

  • Clinical Article - Vascular
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Abstract

Background

Aneurysm recanalization remains a limitation of endovascular treatment. A new type of bioactive coil, the polyglycolic/polylactic acid-covered platinum microfilaments Nexus coil (ev3/Covidien, Irvine, CA, USA), has been proposed. The objective is to evaluate the safety and short-term and mid-term efficacy of Nexus coils in the endovascular treatment of intracranial aneurysms.

Methods

The ENDECOR (European Nexus Detachable Coil Registry) is the first prospective, consecutive, multicenter non-randomized registry. After providing informed consent, 390 patients (238 women and 152 men; mean age, 51.6 years) with 404 ruptured or unruptured aneurysms were enrolled at 34 centers. Treatment was performed with at least 75 % of coil length as Nexus coils. Clinical and technical complications were systematically reported. An independent core laboratory evaluated angiographic results by using the Raymond Grading Scale.

Results

Complete occlusion was seen in 181 aneurysms (48 %); neck remnant in 86 aneurysms (22 %) and aneurysm remnant in 111 aneurysms (30 %). Technical and clinical complications related to the procedure occurred in 33 patients (8.5 %). At discharge, overall mortality and permanent-morbidity were 4.1 % (16/390) and 5.6 % (14/251), respectively. Angiographic mean follow-up of 13.3 months was obtained in 233 of 390 patients (64.4 %) harboring 247 aneurysms. Recanalization was observed in 44 aneurysms (17.7 %), and progressive thrombosis was observed in 53 aneurysms (21.6 %).

Conclusions

Endovascular treatment of intracranial aneurysms with Nexus coils was associated with low morbidity and mortality rates. Efficacy of Nexus coils was comparable to published series of intracranial aneurysms treated with bare platinum coils, but their efficacy to prevent aneurysm recanalization was not demonstrated.

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Acknowledgments

We are grateful to all the investigators and coordinators for the support and hard work in enrolling patients, completing data collection forms, and participating in the study.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Interventional Neuroradiology, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 59 Bd Pinel, 69677, Bron, France

    Benjamin Gory & Francis Turjman

Authors
  1. Benjamin Gory
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  2. Francis Turjman
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Corresponding author

Correspondence to Benjamin Gory.

Additional information

Principal investigators and Investigational site

Supplemental Content. Text that illustrates the principal investigators and investigational sites:

The principal investigators and the investigational site are listed with total patients enrolled in each center in parentheses.

Francis Turjman, Benjamin Gory, Roberto Riva, Hôpital Neurologique, Lyon, France (20); Paolo Apolito, ASL Napoli 1, Napoli, Italy (32); Joachim Klisch, Helios Klinikum Erfurt, Erfurt, Germany (28); André Gaston, Hôpital Henri Mondor, Créteil, France (27); Gyula Gal; Akademiska Sjukhuset, Uppsala, Sweden (20); Maurizio Resta, Ospedale SS. Annunziata, Taranto, Italy (20); Xavier Barreau, Jérôme Berge, Groupe Hospitalier Pellegrin, Bordeaux, France (19); Martin Skalej, Universität Medizinische Fakultät, Magdeburg, Germany (17); Istvan Lazar, Borsod Teaching Hospital, Miskolc, Hungary (16); Karlis Kupcs, Pauls Stradins Clinical University Hospital, Riga, Latvia (16); Vasilios Katsaridis, Papanikolaou General Hospital, Thessaloniki, Greece (15); Patrick Courthéoux, Hôpital de la Côte de Nacre, Caen, France (14); Christophe Cognard, Hôpital Purpan, Toulouse, France (14); Alain Bonafé, Hôpital Gui de Chauilac, Montpellier, France (13); Alexandra Biondi, Fabrice Bonneville, Nader Sourour, Hôpital Pitié Salpétrière, Paris, France (12); Ignacio Hernando, Ricardo Ituarte; Eva Gonzalez Díaz, Hospital de Cruces, Bilbao, Spain (13); Luis López-Ibor, IDC Recoletas, Albacete, Spain (12); Per Jonasson, Norrlands Universitetssjukhus, Umeå, Sweden (10); Antonio Romance, Hospital Carlos Haya, Malaga, Spain (10); Denis Herbreteau, Hôpital Bretonneau, Tours, France (9); Laurent Pierot, CH de Reims, Hôpital de la Maison Blanche, Reims, France (9); Pierre Goffette, CH Saint Luc, Bruxelles, Belgium (9); Juan Macho, Hospital Clinic i Provincial, Barcelona, Spain (8); Serge Bracard, René Anxionnat, Ariel Lebedinski, Hôpital Central, Nancy, France (8); Wolfgang Reith, Universität des Saarlandes, Homburg, Germany (7); José Luis Caniego, Hospital la Princesa, Madrid, Spain (8); Marciej Szajner, Samodzielny Publiczny Szpital Kliniczny, Lublin, Poland (4); Elisa Ciceri, Istituto Neurologico C. Besta, Milano, Italy (3); Michael Forsting, Isabel Wanke, Universitätsklinikum Essen, Essen, Germany (3); René Chapot, Hôpital Dupuytren CHU, Limoges, France (2); Günther Erich Klein, LKH Graz/Universitätskliniken, Graz, Austria (2); Pietro Amista, Neuroradiologia, Azienda Ospedaliera di Padova, Padova, Italy (1); Javier Masso, Jose Angel Larrea, Hospital Donastia, San Sebastian, Spain (1); and Vaclav Procházcka, Faculty Hospital Ostrava Poruba, Czeckoslovakyia Republic (1).

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Gory, B., Turjman, F. Endovascular treatment of 404 intracranial aneurysms treated with nexus detachable coils: short-term and mid-term results from a prospective, consecutive, European multicenter study. Acta Neurochir 156, 831–837 (2014). https://doi.org/10.1007/s00701-014-2047-3

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  • DOI: https://doi.org/10.1007/s00701-014-2047-3

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