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AJNR - American Journal of Neuroradiology

Published ahead of print on February 29, 2008
doi: 10.3174/ajnr.A1021

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Results of 101 Aneurysms Treated with Polyglycolic/Polylactic Acid Microfilament Nexus Coils Compared with Historical Controls Treated with Standard Coils

W.J. van Rooij^a, A.N. de Gast^a and M. Sluzewski^a

^a From the Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands

View larger version (83K): [in this window] [in a new window]   Fig 1. Schematic representation of complex-shaped Nexus coil with interwoven PGLA microfilament threads.

View larger version (160K): [in this window] [in a new window]   Fig 2. A 50-year-old woman with an incidentally discovered unruptured ophthalmic aneurysm. A, Lateral internal carotid angiogram demonstrates 9-mm ophthalmic aneurysm. B, After insertion of three 8 x 30 Nexus Morpheus coils, an adequate basket is formed. C, After failed attempt to deliver and withdrawal of a 7 x 30 Nexus Morpheus coil, coil loops of previous coils are protruding in the parent artery (arrow). D, Final result with coil loops in carotid artery. The patient received Aggrastat infusion for 48 hours, with good clinical outcome.

View larger version (170K): [in this window] [in a new window]   Fig 3. A 62-year-old man with grade III SAH from anterior communicating artery aneurysm. A, Internal carotid angiogram shows bilobated 5-mm anterior communicating artery aneurysm. B, First coil (5 x 15-mm Morpheus) forms adequate basket. C, During insertion of the second coil (2 x 8-mm helical), suddenly a coil loop protruded in the parent artery (arrow). After withdrawal of this coil in the microcatheter, the protruding loop persisted, proving this was a displaced loop of the first coil. D, Final result with persisting protrusion of the coil loop (arrow). Aggrastat infusion was started, with good clinical outcome.

View larger version (195K): [in this window] [in a new window]   Fig 4. A 57-year-old woman with grade II SAH from a middle cerebral artery aneurysm. A, Internal carotid angiogram shows wide-necked 7-mm middle cerebral artery aneurysm. B, Adequate placement of the first coil (7 x 21-mm Morpheus) with assistance of HyperForm 7-mm balloon. C, After deflation of the balloon, there was expansion of the coil with protrusion into the parent artery. This coil was withdrawn. D, Final result after balloon-assisted treatment with GDC 18 coils.