Endosaccular Treatment of Intracranial Aneurysms Using Matrix Coils

Abstract

Background and Purpose-The authors report their experience using Matrix coils in the treatment of cerebral aneurysms. Methods-The outcomes of 72 consecutive patients (76 aneurysms) who underwent coiling using Matrix coils at our institution were retrospectively analyzed. Results-Seventy-four aneurysms in 70 patients were coiled using Matrix coils (ranging 3% to 100% by coil length; mean 68.8%). Two patients underwent regular platinum coil embolization after failed Matrix coil placement. Thirty-two (42%) ruptured aneurysms were acutely treated. In 46 aneurysms, Matrix composed Ͼ50% of coil length. Complete aneurysm occlusion was obtained in 13 aneurysms (17.6%), neck remnant in 30 (40.5%), and dome filling in 31 (41.9%). Procedural morbidity and mortality rates were 1.4% and 1.4%, respectively. Angiographic follow-up was obtained in 63.5% (47 of 74 aneurysms; average 12.2 months; range 0 to 34). In these 47 angiographically followed aneurysms, the overall recanalization rate was 57.4%. In aneurysms with Ͼ50% Matrix coils, 76.1% had angiographic follow-up (35 of 46), and in this group, the overall recanalization rate was 54.3% (19 of 35): 25% (1 of 4) for very small (Ͻ5 mm); 33% (4 of 12) for small-size (Ͻ10 mm)/small-neck (Ͻ4 mm); and 63% (5 of 8) for small-size/wide-neck (Ն4 mm). A total of 82% (9 of 11) recanalization occurred in large aneurysms (Ն10 to 25 mm). Ten aneurysms (21.3%; 10 of 47) underwent retreatment. Clinical follow-up was obtained in 61 (86%) patients (average 15 months; range 1 to 37): 87% of patients were Glasgow Outcome Scale 4 or 5. Conclusion-The use of Matrix coils resulted in worse recanalization rates than that reported for Guglielmi detachable bare platinum coils.

The Barrow Ruptured Aneurysm Trial

“…These coils have since been withdrawn from the market because numerous studies have suggested that aneurysms treated with these coils had unacceptably high recurrence rates. 11,15,16,25,30 It is likely that current endovascular results are, in fact, superior to those reported in this study.…”

Matrix Reloaded

“…This latest publication is noteworthy because it is a very large multicenter series of patients. The results of this publication are disappointing in that they confirm previous findings, [1][2][3][4][5][6][7][8] suggesting that PGLA-coated coils do not lead to a decrease in angiographic recurrence rates relative to platinum coils.…”

Mid-Term Anatomic Results after Endovascular Treatment of Ruptured Intracranial Aneurysms with Guglielmi Detachable Coils and Matrix Coils: Analysis of the CLARITY Series

“…[10][11][12] Several series have evaluated PGLA-coated coils showing a similar safety compared with bare platinum coils. [10][11][12]14 However, no direct comparison between patients harboring aneurysms treated with bare platinum and PGLA-coated coils has been made regarding midterm anatomic results, to our knowledge.…”