American Journal of Neuroradiology 27:1834-1840, October 2006
© 2006 American Society of Neuroradiology
INTERVENTIONAL
Treatment of Cerebral Aneurysms with Hydrogel-Coated Platinum Coils (HydroCoil): Early Single-Center Experience
a Center for Endovascular Surgery, Beth Israel Hyman-Newman Institute for Neurology and Neurosurgery, New York, NY
b Department of Neuro-Ophthalmology, Roosevelt Hospital, New York, NY
c Department Neurological Surgery, Roosevelt Hospital, New York, NY
d Albert Einstein College of Medicine, Bronx, NY
Please address correspondence to Alejandro Berenstein, MD, Center for Endovascular Surgery, Beth Israel Hyman-Newman Institute for Neurology and Neurosurgery, Roosevelt Hospital, GG-15, 1000 10th Ave, New York, NY 10019; e-mail:aberenstein{at}bethisraelny.org
PURPOSE: The authors report their experience using HydroCoils in the treatment of cerebral aneurysms.
METHODS: We performed a retrospective review of the first 100 nonrandomized patients (104 coiled saccular cerebral aneurysms) treated with HydroCoils during a 27-month period.
RESULTS: The average percentage of HydroCoil by length detached in treated aneurysms was 45.5% (range, 9.9–100%). Immediate postprocedure angiography demonstrated complete aneurysm occlusion in 34%, neck remnant in 35%, and incomplete occlusion in 32%. Immediate procedure-related morbidity and mortality rates were 5.8% and 0%, respectively. Angiographic follow-up was obtained in 51% (51/100 patients; 53/104 aneurysms; average, 10.3 months; range, 0–31 months). In these 53 angiographically followed aneurysms, the overall recanalization rate was 21%: no recanalization occurred in 23 aneurysms with small size (<10 mm)/small neck (<4 mm) (S/S); 4 recanalizations occurred in 7 aneurysms with small size/wide neck (>4 mm) (S/W); 6 recanalizations (27%) occurred in 22 large (L) aneurysms (>10–25 mm, 70% angiographic follow-up); and 1 giant (G) (>25 mm) aneurysm recanalized. A large proportion of aneurysms that were not initially completely occluded were completely occluded on follow-up (15/43 [35%]). Clinical follow-up was obtained in 73 patients (73%; average, 5.3 months; range, 0–24 months): 93% of these patients were neurologically improved or unchanged. Three patients rehemorrhaged and 3 patients with unruptured aneurysms developed delayed hydrocephalus.
CONCLUSIONS: The overall safety profile of HydroCoils appears acceptable. Preliminary midterm observations suggest less coil compaction/aneurysm recanalization in large aneurysms. However, HydroCoil-related delayed hydrocephalus is a concern.
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