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Research ArticleInterventional

Embolization of Intracranial Aneurysms with HydroSoft Coils: Results of the Korean Multicenter Study

J.H. Park, H.-S. Kang, M.H. Han, P. Jeon, D.-S. Yoo, T.H. Lee and for the Korean HydroSoft Registry Investigators
American Journal of Neuroradiology October 2011, 32 (9) 1756-1761; DOI: https://doi.org/10.3174/ajnr.A2633
J.H. Park
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H.-S. Kang
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M.H. Han
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P. Jeon
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D.-S. Yoo
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T.H. Lee
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Article Figures & Data

Figures

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  • Fig 1.
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    Fig 1.

    Pre- and postexpansion state of the HydroSoft coil. This platinum coil consists of an inner core of hydrogel and a stretch-resistant filament. It expands and fills up to 40% more volume than a bare platinum coil.

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    Fig 2.

    Improved degree of occlusion. A, A 70-year-old woman with elective coiling of a posterior communicating artery aneurysm. Postembolization angiogram shows residual filling into the aneurysm sac (arrow). B, A 7-month follow-up angiogram shows complete obliteration of the aneurysm lumen (arrow).

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    Fig 3.

    Improved degree of occlusion. A, A 40-year-old man with a ruptured anterior communicating artery aneurysm. Immediate postembolization angiogram demonstrates residual filling into the aneurysmal sac. B, An 8-month follow-up angiogram shows complete occlusion of aneurysmal sac.

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    Fig 4.

    Worsened degree of occlusion. A, A 60-year-old woman with a paraclinoid aneurysm. Immediate postembolization angiogram shows complete occlusion of the aneurysm. B, A 1-year follow-up angiogram reveals minor recanalization at the neck.

Tables

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    Table 1:

    Demographics of patients treated with HydroSoft coils

    No. of Patients120
    Sex (M:F)43:77
    Age, yr
        mean; range56.6; 30–80
    No. of treated aneurysms127
        Ruptured35 (28%)
        Unruptured92 (72%)
    Aneurysm location
        Internal carotid artery69 (54%)
        Anterior cerebral artery41 (33%)
        Middle cerebral artery8 (6%)
        Posterior circulation9 (7%)
    Aneurysm size
        < 5 mm64 (50%)
        5 mm < 8 mm54 (43%)
        8 mm < 10 mm9 (7%)
    Aneurysm volume
        mean; range55 mm3; 5- 249
        < 100 mm3106 (83%)
        ≥ 100 mm321 (17%)
    • View popup
    Table 2:

    Procedure-related complications in 127 procedures

    ComplicationsNo.MorbidityMortality
    Thromboembolism210
    Procedural bleeding5*00
    Total6 (4.7%)1 (0.8%)0 (0%)
    • ↵* One patient showed procedural bleeding as well as thromboembolism.

    • View popup
    Table 3:

    Degree of aneurysmal occlusion at immediately postprocedure and at the last follow-up

    Angiographic ResultsImmediateFollow-Up
    StationaryImprovedWorse
    Class 1; complete87 (69%)72 (97)NA2 (3)
    Class 2; residual neck25 (19%)5 (28)12 (67)1 (5)
    Class 3; residual sac15 (12%)4 (31)9 (69)NA
    Total12781 (79)21 (18)3 (3)
    • Note:—The numbers in parentheses are percentages.

    • View popup
    Table 4:

    Cases showing recanalization in HydroSoft coil group

    Patient No./Sex/ Age (yr)Type of RecanalizationH-HLocationSize (mm)PD (%)%HSInterval (mo)
    8/M/47Minor1SCA6.1 × 5.3 × 4.924648
    21/M/46Major4ACA3.8 × 2.4 × 2.3731006
    75/F/63Major2Basilar7.0 × 7.5 × 8.5305110
    • H-H indicates Hunt and Hess grade; PD, packing density; % HS, % length of HydroSoft coils among total coils deployed; Interval, interval from coil embolization to diagnosis of aneurysm recanalization; SCA, superior cerebellar artery; ACA, anterior cerebral artery.

    • View popup
    Table 5:

    Results of regression analysis for variables related to aneurysm recanalization

    VariableP Value
    Simple Logistic Regression AnalysisMultiple Logistic Regression Analysis
    % length of HydroSoft coils0.5810.622
    Presentation, ruptured versus unruptured0.001*0.002*
    Maximal aneurysm diameter0.8900.440
    Aneurysm volume0.0810.062
    Aneurysm location, anterior versus posterior circulation0.4400.542
    Degree of occlusion, incomplete versus complete or near complete0.0610.155
    Packing attenuation0.4170.103
    • ↵* Statistically significant

    • View popup
    Table 6:

    Bare platinum or coated coil experiences with follow-up results in the literature

    Series (ref. no.)Coating MaterialNo. of AneurysmsMajor RecanalizationMean Follow-Up IntervalStudy Design
    Sluzewski et al.20None14528%6 monthsRetrospective, single-center
    Kagn et al.2PGLA3913%6 monthsRetrospective, single-center
    Niimi et al.21PGLA4721%12 monthsRetrospective, single-center
    Gunnarsson et al.22Hydrogel12122%16 monthsRetrospective, single-center
    Current studyHydrogel1272%11 monthsProspective, multicenter
    • PGLA indicates polyglycolic acid/lactide copolymer

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American Journal of Neuroradiology: 32 (9)
American Journal of Neuroradiology
Vol. 32, Issue 9
1 Oct 2011
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Embolization of Intracranial Aneurysms with HydroSoft Coils: Results of the Korean Multicenter Study
J.H. Park, H.-S. Kang, M.H. Han, P. Jeon, D.-S. Yoo, T.H. Lee, for the Korean HydroSoft Registry Investigators
American Journal of Neuroradiology Oct 2011, 32 (9) 1756-1761; DOI: 10.3174/ajnr.A2633

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Embolization of Intracranial Aneurysms with HydroSoft Coils: Results of the Korean Multicenter Study
J.H. Park, H.-S. Kang, M.H. Han, P. Jeon, D.-S. Yoo, T.H. Lee, for the Korean HydroSoft Registry Investigators
American Journal of Neuroradiology Oct 2011, 32 (9) 1756-1761; DOI: 10.3174/ajnr.A2633
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  • Coil Type Does Not Affect Angiographic Follow-Up Outcomes of Cerebral Aneurysm Coiling: A Systematic Review and Meta-Analysis
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