H J Cloft1. 1. Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA. cloft.harry@mayo.edu
Abstract
BACKGROUND AND PURPOSE: The HydroCoil Embolic System (HES) was developed reduce recurrences of aneurysms relative to platinum coils. This study was conducted to evaluate the recurrence rate of cerebral aneurysms 3-6 months after treatment with HES. METHODS: We report the results in 135 cerebral aneurysms treated with HES in a prospective multicenter registry. Angiographic results 3-6 months after treatment were evaluated at a core laboratory. Wide variation in HES utilization within the HydroCoil for Endovascular Aneurysm Occlusion (HEAL) registry (HES representing 5% to 100% of the coil length used) allowed for subgroup analysis with regard to percentage length, last coil used, and packing attenuation in small (<10 mm) aneurysms. RESULTS: The overall recurrence rate was 38 (28.1%) of 135, which included a number of large, giant, and previously recurrent aneurysms. When HES represented > or = 75% of coil length, the recurrence rate was 0 (0%) of 18, whereas with <75% length of HES, the recurrence rate was 16 (23%) of 71 (P = .035). When the final coil deposited was a HES coil, the recurrence rate was 6 (11%) of 53, whereas when the final coil was platinum, the recurrence rate was 10 (29%) of 34 (P = .047). When the packing attenuation was > or = 50%, the recurrence rate was 11 (19%) of 59, whereas for packing attenuation <50%, the recurrence rate was 5 (18%) of 28. The packing attenuation calculations were very error-prone. CONCLUSION: Although the overall recurrence rates for small and large aneurysms in HEAL were no lower than published rates for aneurysms treated with platinum coils, patients treated in HEAL had a reduced recurrence rate when greater than 75% of the coil length used to treat an aneurysm was HES and when the final coil was HES.
BACKGROUND AND PURPOSE: The HydroCoil Embolic System (HES) was developed reduce recurrences of aneurysms relative to platinum coils. This study was conducted to evaluate the recurrence rate of cerebral aneurysms 3-6 months after treatment with HES. METHODS: We report the results in 135 cerebral aneurysms treated with HES in a prospective multicenter registry. Angiographic results 3-6 months after treatment were evaluated at a core laboratory. Wide variation in HES utilization within the HydroCoil for Endovascular Aneurysm Occlusion (HEAL) registry (HES representing 5% to 100% of the coil length used) allowed for subgroup analysis with regard to percentage length, last coil used, and packing attenuation in small (<10 mm) aneurysms. RESULTS: The overall recurrence rate was 38 (28.1%) of 135, which included a number of large, giant, and previously recurrent aneurysms. When HES represented > or = 75% of coil length, the recurrence rate was 0 (0%) of 18, whereas with <75% length of HES, the recurrence rate was 16 (23%) of 71 (P = .035). When the final coil deposited was a HES coil, the recurrence rate was 6 (11%) of 53, whereas when the final coil was platinum, the recurrence rate was 10 (29%) of 34 (P = .047). When the packing attenuation was > or = 50%, the recurrence rate was 11 (19%) of 59, whereas for packing attenuation <50%, the recurrence rate was 5 (18%) of 28. The packing attenuation calculations were very error-prone. CONCLUSION: Although the overall recurrence rates for small and large aneurysms in HEAL were no lower than published rates for aneurysms treated with platinum coils, patients treated in HEAL had a reduced recurrence rate when greater than 75% of the coil length used to treat an aneurysm was HES and when the final coil was HES.
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