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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:283-288, February 2006
© 2006 American Society of Neuroradiology

INTERVENTIONAL

Histopathologic Evaluation of Aneurysms Treated with Guglielmi Detachable Coils or Matrix Detachable Microcoils

I. Szikora^a, P. Seifert^b, Z. Hanzely^a, Z. Kulcsar^a, Z. Berentei^a, M. Marosfoi^a, S. Czirjak^a, J. Vajda^a and I. Nyary^a

^a National Institute of Neurosurgery, Budapest, Hungary
^b Boston Scientific Neurovascular, Fremont, Calif

Address correspondence to Istvan Szikora, National Institute of Neurosurgery, Amerikai ut 57, H-1145, Budapest, Hungary

BACKGROUND AND PURPOSE: The purpose of this study was to evaluate the degree of organization and fibrocellular tissue development in aneurysms treated with bare platinum or biologically active microcoils.

METHODS: Twelve aneurysms were removed at autopsy between 1–18 days and another 2 between 2–3 months posttreatment. Four aneurysms were surgically removed between 6 months and 3 years following treatment. One aneurysm removed at 8 days and another at 6 months were treated with bioactive (Matrix) coils; the other 16 with bare platinum (Guglielmi detachable coils; GDCs). All specimens were embedded in plastic, stained with hematoxilin-eosin and elastin and examined by light microscopy.

RESULTS: All specimens removed within 3 weeks demonstrated intra-aneurysmal thrombus, without signs of organization or fibrotic tissue formation over the neck regardless of the type of coils used. In the GDC-treated aneurysms, evidence of early thrombus organization was observed within 2–3 months, and completed yet imperfect fibrocellular reaction together with residual thrombus at 2–3 years. In the Matrix-treated specimens, the aneurysm cavity was completely filled with granulation tissue corresponding to still ongoing fibrocellular reaction at 6 months, including newly formed blood vessels, smooth muscle cells, and collagen deposition without signs of residual thrombus.

CONCLUSIONS: Our results indicate that in aneurysms treated with bare platinum coils thrombus organization does not occur until late after treatment and may remain imperfect for years. In one aneurysm studied 8 days following treatment with Matrix coils, no difference was noted compared to aneurysms treated with bare platinum coils. In another aneurysm examined 6 months following packing with Matrix coils, the histologic changes support the hypothesis that the biologically active polymer may accelerate aneurysm healing.

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