Division of Interventional Neuroradiology, Department of Neurological Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, New York 10021, USA.
Neurosurgery. 2011 Sep;69(3):557-64; discussion 565. doi: 10.1227/NEU.0b013e31821a86da.
Despite increasing acceptance of endovascular coiling for treating intracranial aneurysms, incomplete occlusion remains a limitation. Attempts to reduce recanalization have prompted creation of polyglycolic/polylactic acid-coated (Matrix) coils shown to improve neointima formation; however, previous publications demonstrate conflicting results regarding their efficacy. Few studies account for factors influencing recurrence, and only 4 studies include bare platinum (BP) coil control groups.
To compare initial and short- and mid-term occlusion as well as retreatment rates using Matrix compared with BP coils.
Retrospective review of patients undergoing coiling of cerebral aneurysms from 2001 to 2005 was performed. Analysis included a multivariate logistic regression model designed to detect a 35% absolute difference in initial occlusion between coil treatment groups with 80% power.
Complete initial occlusion was achieved in 64% of BP (n = 45) and 63% of Matrix (n = 56) cases (P = 1.0). Follow-up occlusion rates in the short term and mid term were 52% and 60%, respectively, for BP cases and 42% and 67%, respectively, for Matrix cases (P = .24 and P = .38, respectively). After adjusting for size, morphology, volumetric packing density, location, rupture, and balloon remodeling, no difference in initial and subsequent occlusion or retreatment rates for BP coils versus Matrix coils was appreciated.
After controlling for factors influencing recanalization, this investigation failed to show a significant difference between coil groups.
尽管血管内线圈栓塞术治疗颅内动脉瘤的接受程度不断提高，但不完全闭塞仍然是一个限制。为了减少再通，人们试图制造聚乙醇酸/聚乳酸涂层（Matrix）线圈，这些线圈已被证明可以改善新生内膜形成；然而，以前的出版物显示其疗效存在矛盾。很少有研究考虑到影响复发的因素，只有 4 项研究包括裸铂（BP）线圈对照组。
比较 Matrix 线圈与 BP 线圈在初始和短期及中期闭塞以及再治疗率方面的效果。
对 2001 年至 2005 年间接受脑动脉瘤线圈栓塞治疗的患者进行回顾性研究。分析包括一个多变量逻辑回归模型，旨在检测两组线圈治疗在初始闭塞方面有 35%的绝对差异，具有 80%的功效。
BP 组（n = 45）完全初始闭塞率为 64%，Matrix 组（n = 56）为 63%（P = 1.0）。BP 组的短期和中期随访闭塞率分别为 52%和 60%，Matrix 组分别为 42%和 67%（P =.24 和 P =.38）。在调整大小、形态、体积填充密度、位置、破裂和球囊重塑等因素后，BP 线圈与 Matrix 线圈在初始和随后的闭塞或再治疗率方面没有差异。
在控制再通影响因素后，本研究未能显示两组线圈之间存在显著差异。
