van Rooij W J, de Gast A N, Sluzewski M
Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands.
AJNR Am J Neuroradiol. 2008 May;29(5):991-6. doi: 10.3174/ajnr.A1021. Epub 2008 Feb 29.
Polyglycolic/polylactic acid (PGLA) addition to bare platinum coils is intended to reduce the reopening rate of coiled intracranial aneurysms. Nexus coils are standard complex platinum coils with interwoven PGLA microfilament threads. We present the clinical results of 101 intracranial aneurysms treated with Nexus coils.
Results of coiling of 101 aneurysms treated with Nexus coils were compared with our results of coiling of 120 aneurysms with Guglielmi detachable coils (GDC 10) and 115 with Trufill coils treated between May 2003 and December 2004 with the same treatment protocol. Rate of complications, mean aneurysmal volume, packing attenuation, incomplete aneurysmal occlusion at 6 months, and rates of retreatment were compared.
Initial occlusion in aneurysms treated with Nexus coils was (near) complete in 97 aneurysms and incomplete in 4 aneurysms. There were no permanent procedural complications (0/95 patients, 0%; 97.5% CI, 0.0% to 3.3%). Mean aneurysmal volume was 180.2 mm(3) (range, 5-1624 mm(3)). Mean packing was 19.4% (range, 7.5% to 38.9%). Six months' angiographic follow-up in 87 of 101 aneurysms showed incomplete occlusion in 14 (16%), and 12 (14%) of those had additional coiling. Mean packing of 19.4% of Nexus coils was significantly lower than 22.9% for GDC 10 and 29.7% for Trufill coils. Other clinical results were not significantly different.
In this series, PGLA microfilament Nexus coils were safe to use with clinical results comparable with those of standard platinum coils. This study gives additional evidence of the lack of beneficial effect of PGLA addition to reduce the reopening rate of coiled intracranial aneurysms.
在裸铂弹簧圈中添加聚乙醇酸/聚乳酸(PGLA)旨在降低颅内动脉瘤弹簧圈栓塞后的再通率。Nexus弹簧圈是带有交织PGLA微丝的标准复杂铂弹簧圈。我们展示了使用Nexus弹簧圈治疗101例颅内动脉瘤的临床结果。
将使用Nexus弹簧圈治疗101例动脉瘤的栓塞结果,与我们在2003年5月至2004年12月期间采用相同治疗方案使用Guglielmi可脱性弹簧圈(GDC 10)治疗120例动脉瘤以及使用Trufill弹簧圈治疗115例动脉瘤的结果进行比较。比较并发症发生率、动脉瘤平均体积、填塞率、6个月时动脉瘤不完全栓塞情况以及再次治疗率。
使用Nexus弹簧圈治疗的动脉瘤中,97例初始栓塞(接近)完全,4例不完全。无永久性手术并发症(0/95例患者,0%;97.5%可信区间,0.0%至3.3%)。动脉瘤平均体积为180.2立方毫米(范围5至1624立方毫米)。平均填塞率为19.4%(范围7.5%至38.9%)。101例动脉瘤中的87例进行了6个月的血管造影随访,14例(16%)显示不完全栓塞,其中12例(14%)进行了额外的弹簧圈栓塞。Nexus弹簧圈19.4%的平均填塞率显著低于GDC 10的22.9%和Trufill弹簧圈의29.7%。其他临床结果无显著差异。
在本系列研究中,PGLA微丝Nexus弹簧圈使用安全,临床结果与标准铂弹簧圈相当。本研究进一步证明添加PGLA对降低颅内动脉瘤弹簧圈栓塞后再通率并无益处。