Cloft H J
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
AJNR Am J Neuroradiol. 2007 Jan;28(1):152-4.
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.
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.
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.
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.
相对于铂金线圈，HydroCoil栓塞系统（HES）的研发旨在降低动脉瘤的复发率。本研究旨在评估使用HES治疗3至6个月后脑动脉瘤的复发率。
我们在一项前瞻性多中心登记研究中报告了135例接受HES治疗的脑动脉瘤的结果。治疗后3至6个月的血管造影结果在一个核心实验室进行评估。血管内动脉瘤栓塞HydroCoil（HEAL）登记研究中HES使用情况差异很大（HES占所用线圈长度的5%至100%），这使得能够对小（<10 mm）动脉瘤的百分比长度、最后使用的线圈以及填塞密度进行亚组分析。
135例患者中总体复发率为38例（28.1%），其中包括一些大型、巨大型和既往复发的动脉瘤。当HES占线圈长度≥75%时，18例患者的复发率为0（0%），而当HES长度<75%时，71例患者中有16例（23%）复发（P = 0.035）。当最后置入的线圈是HES线圈时，53例患者中有6例（11%）复发，而当最后置入的线圈是铂金线圈时，34例患者中有10例（29%）复发（P = 0.047）。当填塞密度≥50%时，59例患者中有11例（19%）复发，而当填塞密度<50%时，28例患者中有5例（18%）复发。填塞密度计算非常容易出错。
尽管HEAL研究中大小动脉瘤的总体复发率不低于已发表的使用铂金线圈治疗动脉瘤的复发率，但在HEAL研究中，当用于治疗动脉瘤的线圈长度超过75%为HES且最后置入的线圈为HES时，患者的复发率降低。
