Kang Hyun-Seung, Han Moon Hee, Kwon Bae Ju, Kwon O-Ki, Kim Sung Hyun, Choi Seung Hong, Chang Kee-Hyun
Department of Neurosurgery, Konkuk University Hospital,Seoul, Republic of Korea.
AJNR Am J Neuroradiol. 2005 Sep;26(8):1921-8.
Aneurysm recanalization is an innate problem in endovascular treatment of aneurysms with coils. A coated coil system, covered with a bioabsorbable polymeric material (polyglycolic acid/lactide copolymer, PGLA), was developed to accelerate intra-aneurysmal clot organization and fibrosis. The purpose of this study was to evaluate the efficacy and safety of the PGLA-coated coils in patients with intracranial aneurysms and to compare the outcome with that of bare platinum coils.
Fifty-one patients harboring 56 intracranial aneurysms underwent endovascular embolization with the PGLA-coated coils. In the control group were 78 consecutive patients, harboring 87 aneurysms, who underwent coil embolization with bare platinum coils. The authors compared coil volume, packing attenuation, degree of occlusion of aneurysms, procedure-related complications, and follow-up results between the 2 groups.
The PGLA-coil group showed comparable data regarding rate of total or near-total occlusion of the aneurysm, incidence procedure-related thromboembolism, and management outcome. Mean coil volume deployed and packing attenuation of the PGLA-coil group were significantly higher than those of the bare-coil group (P = .0026 and P < .0001, respectively). Radiologic follow-up evaluation revealed recanalization in 14 of 39 aneurysms (major recanalization in 5 [13%] and minor recanalization in 9 [23%]) among the PGLA-coil group and in 29 of 64 aneurysms (major recanalization in 9 [14%] and minor recanalization in 20 [31%]) among the bare-coil group.
In this study, the incidence of recanalization was not different in aneurysms treated with PGLA-coated coils compared with historical controls treated with bare platinum coils.
动脉瘤再通是使用弹簧圈进行动脉瘤血管内治疗时的一个固有问题。一种覆盖有生物可吸收聚合物材料(聚乙醇酸/丙交酯共聚物,PGLA)的涂层弹簧圈系统被研发出来,以加速动脉瘤内血栓形成和纤维化。本研究的目的是评估PGLA涂层弹簧圈治疗颅内动脉瘤患者的疗效和安全性,并将结果与裸铂弹簧圈进行比较。
51例患有56个颅内动脉瘤的患者接受了PGLA涂层弹簧圈的血管内栓塞治疗。对照组为78例连续患者,患有87个动脉瘤,接受了裸铂弹簧圈的栓塞治疗。作者比较了两组之间的弹簧圈体积、填充衰减、动脉瘤闭塞程度、与手术相关的并发症以及随访结果。
PGLA弹簧圈组在动脉瘤完全或接近完全闭塞率、与手术相关的血栓栓塞发生率以及治疗结果方面显示出可比的数据。PGLA弹簧圈组的平均弹簧圈植入体积和填充衰减明显高于裸弹簧圈组(分别为P = 0.0026和P < 0.0001)。影像学随访评估显示,PGLA弹簧圈组39个动脉瘤中有14个发生再通(5个[13%]为主要再通,9个[23%]为次要再通),裸弹簧圈组64个动脉瘤中有29个发生再通(9个[14%]为主要再通,20个[31%]为次要再通)。
在本研究中,与使用裸铂弹簧圈治疗的历史对照组相比,使用PGLA涂层弹簧圈治疗的动脉瘤再通发生率没有差异。