Department of Neuroradiology, Cork University Hospital, Wilton, Ireland.
AJNR Am J Neuroradiol. 2010 Nov;31(10):1917-22. doi: 10.3174/ajnr.A2210. Epub 2010 Aug 12.
The HydroCoil is an expansile hydrogel coil designed to produce a greater degree of volumetric packing within cerebral aneurysms when compared with bare platinum coils. This increased packing is, in turn, believed to decrease the risk of recurrence within aneurysms and hence the risk of their rupture in the long term. The aim of this work was to assess whether the use of HydroCoils and the proportion of HydroCoil used have any influence on the subsequent occlusion and recurrence rates of treated aneurysms.
A retrospective study was performed of 328 patients during 5 years at a single institution. The initial angiographic and follow-up angiographic occlusion rates were recorded as were any procedural complications. The proportion of HydroCoil used was described as the relative amount of HydroCoil length to the total coil length used during an aneurysm treatment, thus forming 4 groups: 0%-19%, 20%-49%, 50%-69%, 70%-100%, and the subgroups with 100%.
Two hundred seventy patients had angiographic follow-up during an average of 13 months. The overall risk of permanent neurologic deficit and death was 3%. The rate of complete occlusion was 31% immediately postcoiling and 64.8% on follow-up. At the latest follow-up, 25.6% had residual necks and 9.6% had residual aneurysms. There was a statistically significant trend for HydroCoils to produce greater occlusion rates on follow-up when >70% HydroCoil was used (P = .025). The overall rate of recurrence for all aneurysms as a group was 15.5%. The retreatment rate was 6.6%. There has been 1 rebleed in the 328 patients.
The overall results following the use of HydroCoils to occlude aneurysms compare well with those in other reported series. HydroCoils do produce a statistically significantly greater rate of occlusion when >70% of total aneurysm coil length is HydroCoil compared with coiling with <20% HydroCoil. There was no significant difference, however, in the recurrence or retreatment rate when comparing these groups.
HydroCoil 是一种可扩张的水凝胶圈，与裸铂金圈相比，其设计目的是在脑动脉瘤内实现更大程度的体积填充。这种填充度的增加，反过来又被认为降低了动脉瘤内复发的风险，从而降低了长期破裂的风险。本研究旨在评估 HydroCoil 的使用及其使用比例是否对治疗后动脉瘤的闭塞和复发率有任何影响。
在一家单机构的 5 年时间里，对 328 名患者进行了回顾性研究。记录了初始血管造影和随访血管造影的闭塞率以及任何程序并发症。HydroCoil 的使用比例描述为 HydroCoil 长度与动脉瘤治疗过程中使用的总线圈长度的相对比例，从而形成 4 个组：0%-19%、20%-49%、50%-69%、70%-100%，以及 100%的亚组。
270 名患者在平均 13 个月的时间内进行了血管造影随访。永久性神经功能缺损和死亡的总风险为 3%。即刻 coil 后完全闭塞率为 31%，随访时为 64.8%。在最近的随访中，25.6%有残余颈部，9.6%有残余动脉瘤。当>70%的 HydroCoil 用于 coil 时，在随访中产生更大的闭塞率呈统计学显著趋势（P=0.025）。所有动脉瘤作为一个组的总体复发率为 15.5%。再治疗率为 6.6%。在 328 名患者中，有 1 例再出血。
与其他报道的系列相比，使用 HydroCoil 闭塞动脉瘤的总体结果相当。与 coil 中使用<20%的 HydroCoil 相比，当 coil 中使用>70%的 HydroCoil 时，HydroCoil 的闭塞率呈统计学显著增加。然而，在比较这些组时，复发或再治疗率没有显著差异。
