A single centre study of coil embolization of intracranial aneurysms comparing bare platinum and PGLA-coated coils.

Abstract

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.

• Authors: R S Bose, R J Dowling, B Yan, P J Mitchell
• Journal: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (J Clin Neurosci) Vol. 19 Issue 2 Pg. 271-6 (Feb 2012) ISSN: 1532-2653 [Electronic] Scotland
• PMID: 22260957 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2011 Elsevier Ltd. All rights reserved.

Chemical References

• Antimicrobial Cationic Peptides
• Coated Materials, Biocompatible
• peptide-Gly-Leu-amide
• Platinum

Topics

• Adult
• Aged
• Antimicrobial Cationic Peptides (administration & dosage)
• Coated Materials, Biocompatible (administration & dosage)
• Cohort Studies
• Embolization, Therapeutic (instrumentation, methods)
• Female
• Follow-Up Studies
• Humans
• Intracranial Aneurysm (pathology, therapy)
• Male
• Middle Aged
• Platinum (administration & dosage)
• Treatment Outcome