There is no robust consensus on the efficacy of polyglycolic/
polylactic acid (
PGLA)-coated coils used in the endovascular embolization of
intracranial aneurysms. We present a comparative study of bare
platinum coils and
PGLA-coated Gugliemi Detachable Coils (GDC) in the treatment of
intracranial aneurysms at a single centre, using target
aneurysm recurrence and angiographic recanalization as the primary endpoints. We included all patients treated between 1998 and 2009 who had undergone at least one angiographic post-procedural follow-up. Patient demographics, clinical presentation, operative notes, and all relevant imaging were collected. Of the 441
aneurysms with follow-up, 290 were treated with at least one
PGLA coil and 151
aneurysms were treated exclusively with bare
platinum coils. At follow-up, 26.5% of
platinum controls demonstrated angiographic recanalization, compared to 31.4% of
PGLA-treated
aneurysms (p=0.002).
PGLA-treated
aneurysms were more likely to have an angiographic remnant at follow-up (odds ratio [OR]=1.96, 95% confidence interval [CI]=1.26-3.04, p=0.003). The post-operative Raymond score was the only predictor of
retreatment (OR=1.6, 95% CI=1.08-2.24, p=0.020), and was the second strongest predictor of a complete angiographic result at follow-up (OR=1.67, 95% CI=1.22-2.27, p=0.001). We concluded that
PGLA-coated coils demonstrated poorer post-operative and long-term angiographic occlusion in the treatment of
intracranial aneurysms, compared to bare
platinum coils.