Coil Type Does Not Affect Angiographic Follow-Up Outcomes of Cerebral Aneurysm Coiling: A Systematic Review and Meta-Analysis

Abstract

BACKGROUND AND PURPOSE:Previous studies varied in their conclusions about the superiority of second-generation coils compared with bare platinum. In this systematic review and meta-analysis, we assessed differences in reported unfavorable angiographic outcomes of cerebral aneurysms treated with coil embolization as a function of coil type.

In Memoriam: The Matrix Coil

“…1 Although several previous studies indicated similar results, [2][3][4] this MAPS trial is the death blow for the "bioactive" coil. This is good news for patients and hospitals because the spilling of money by the excessive costs of these coils can now be avoided without compromising patient care.…”

HydroCoils Are Associated with Lower Angiographic Recurrence Rates Than Are Bare Platinum Coils in Treatment of “Difficult-to-Treat” Aneurysms: A Post Hoc Subgroup Analysis of the HELPS Trial

“…One meta-analysis of 82 studies found no dif- ference in angiographic outcomes between bare platinum coils, HydroCoils, and Cerecyte coils (Codman Neurovascular, Raynham, Massachusetts). 22 However, no subgroup analyses were performed to examine the relative benefits of modified coils in easily identified difficult-to-treat subgroups, such as wide-neck or irregularly shaped aneurysms. Single-center studies have found that, when compared with bare platinum coils, HydroCoils are associated with decreased recurrence rates; however, none was a randomized controlled trial, and many were too small for subgroup analyses to define which patients may benefit most from HydroCoil treatment.…”

Endovascular Treatment of Cerebral Aneurysms Using the Hydrocoil Embolic System

“…Its use is based on the concept of filling the intra-aneurysmal space with a non-absorbable polymer and thus, rendering the aneurysmal packing independent of clot formation [15][16][17][18][19][20][21] . The HES system is a hybrid device made of platinum and hydrogel in a 30:70 ratio.…”

“…These HELPS results reinforced coiling as an effective treatment for aneurysms, with an excellent technical success rate although bare coils and HES presented an equivalent risk profile 28,29,37,38 . A recent meta-analysis reviewed the literature in the years 1999-2011 19 . Unfavorable angiographic outcomes of cerebral aneurysms treated with coil embolization as a function of coil type were analyzed.…”

“…wide-neck, giant and fusiform aneurysms [9][10][11][12][13][14]21,31,33 . A recent meta-analysis has shown unfavorable angiographic outcome rates of 20% for bare platinum coils, and 15% for the HydroCoil Embolic System 19 . Although the difference in unfavorable outcome rates among the various coil types was not statistically significant we were encouraged to retrospectively review a series of out neurologic deficit), two HH3 (drowsiness/ confusion, mild focal neurologic deficit) and two HH4 (stupor, moderate/severe hemiparesis).…”