Short-Term Outcome of Intracranial Aneurysms Treated with Polyglycolic Acid/Lactide Copolymer–Coated Coils Compared to Historical Controls Treated with Bare Platinum Coils: A Single-Center Experience
Hyun-Seung Kanga,
Moon Hee Hanb,c,
Bae Ju Kwonb,
O-Ki Kwonc,
Sung Hyun Kimb,
Seung Hong Choib and
Kee-Hyun Changb
a Department of Neurosurgery, Konkuk University Hospital,Seoul, Republic of Korea
b Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
c Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
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FIG 1. Complete occlusion. Pre-embolization angiogram (A) and postembolization angiogram (B). Complete occlusion was achieved in the anterior communicating aneurysm of a 62-year-old woman. This unruptured aneurysm measured 8.2 mm x 6.0 mm x 6.8 mm. A total of 19 coils (136 cm) were deployed, of which 13 (116 cm) were PGLA-coated. Packing attenuation was calculated to be 68%.
Near-complete occlusion. Pre-embolization angiogram (C) and postembolization angiogram (D). Near-complete occlusion was achieved in the basilar top aneurysm of a 38-year-old man, presenting with subarachnoid hemorrhage. This aneurysm measured 12.8 mm x 10.2 mm x 10.9 mm. A total of 11 coils (185 cm) were deployed, of which 6 (105 cm) were PGLA-coated. Tiny contrast-filled spaces are seen near neck of the aneurysm. Packing attenuation was calculated to be 19%.
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FIG 2. Minor recanalization. Pre-embolization angiogram (A), postembolization angiogram (B), and control angiogram at 12 months postembolization (C). Near-complete occlusion was achieved in the unruptured internal carotid artery aneurysm of a 61-year-old woman (B). Follow-up angiogram (C) shows minimal recanalization of the aneurysm neck with compaction of the coil mesh (arrow).
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FIG 3. Major recanalization. Pre-embolization angiogram (A), postembolization angiogram (B), and control angiogram at 7 months postembolization (C). Complete occlusion was achieved in the ruptured anterior communicating artery aneurysm of a 35-year-old man (B). Follow-up angiogram (C) shows significant recanalization of the aneurysm; coil mesh is compacted into the dome of aneurysm and loosened at its upper aspect (arrow).
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FIG 4. Relationship between coil volumes and aneurysm volumes. Graph shows a linear relationship between the aneurysm volumes and the coil volumes in either group. Coil volume and aneurysm volume are expressed in logarithmic scales. Overall spots of the PGLA-coil group are located higher than those of control group.
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FIG 5. Relationship between packing densities and aneurysm volumes. Graph shows an inverse relationship between the aneurysm volumes and the packing densities in either group. Aneurysm volume is expressed in a logarithmic scale. Overall spots of the PGLA-coil group are located higher than those of control group.
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FIG 6. Paths of follow-up in PGLA-coil group (A) and bare-coil group (B). There are no significant differences in the recanalization rates between two groups. CA, conventional angiography.
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FIG 7. Recanalization rate according to packing attenuation group in PGLA-coil group (A, P = .0016) and bare-coil group (B, P = .0837). Gray bars represent percentages of aneurysms showing recanalization and white bars those showing stable occlusion at follow-up imaging. With increasing packing densities less percentage of aneurysms become recanalized in either group ( 2 test for trend).
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