Mid-term Outcomes Comparison of Intracranial Aneurysms Treated with Polyglycolic Acid/Lactide Copolymer-Coated Coils Versus Bare Platinum Coils.

Jung,  Cheolkyu; Han,  Moon Hee; Kang,  Hyun Seung; Kwon,  Bae Ju; Kim,  Jeong Eun; Oh,  Chang Wan

Original Article

Neurointervention 2007;2(2):89-96.

Cheolkyu Jung, Moon Hee Han, Hyun Seung Kang, Bae Ju Kwon, Jeong Eun Kim, Chang Wan Oh

¹Department of Radiology, Hanyang University College of Medicine, Korea.
²Department of Radiology, Seoul National University College of Medicine, Korea. hanmh@radcom.snu.ac.kr
³Department of Neurosurgery, Seoul National University College of Medicine, Korea.
⁴Clinical Research Institute, Seoul National University Hospital, Korea.
⁵Institute of Radiation Medicine, Seoul National University Medical Research Center, Korea.
⁶Department of Neurosurgery, Konkuk University Hospital, Korea.
⁷Neuroscience Center, Seoul National University Bundang Hospital, Korea.

Abstract

PURPOSE
A coated coil system, covered with a bioabsorbable polymeric material (polyglycolic acid/lactide copolymer, PGLA), was developed to accelerate intra-aneurysmal clot organization and fibrosis, and thereby to reduce aneurysm recanalization. As a continuation of a previously published study that included analysis of short-term outcomes of endosaccular coil embolization of intracranial saccular aneurysm within 6 months, the purpose of this study was to evaluate the mid-term results of PGLA-coated coils in patients with intracranial aneurysms and to compare results with those of bare platinum coils. PATIENTS AND METHODS: Fifty-one patients harboring 56 intracranial aneurysms underwent endovascular embolization with PGLA-coated coils. The control group included 78 consecutive patients, harboring 87 aneurysms, who underwent coil embolization with bare platinum coils. The authors compared mid-term follow-up results in these two groups retrospectively.
RESULTS
The median follow-up interval for radiologic evaluation was 12 months (range 5 to 18 months) and 14 months (range 6 to 30 months) in the PGLA-coil group and the bare-coil group, respectively. Major aneurysm recanalization occurred in 9 of 43 aneurysms (20.9%) in the PGLA-coil group and in 13 of 64 aneurysms (20%) in the bare-coil group. Notably, the rate of major recanalization (46.2%) in the PGLA coil group with a packing density of <25% was significantly higher than that of the bare coil group (17.8%).
CONCLUSION
In spite of a similar incidence of recanalization between the PGLA-coated coil and bare platinum coil groups, the major recanalization rate of this group was significantly higher than that of the bare coil group, if packing density of more than 25% was not achieved using PGLA-coated coils. So we can conclude that dense packing is more likely to have an effect on treatment result rather than does biological effect of PGLA in case of endosaccular coil embolization using PGLA-coated coils.

Key Words: Aneurysm; Coil embolization; PGLA