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与使用裸铂线圈治疗的历史对照相比,使用HydroSoft线圈治疗颅内动脉瘤的中期结果:单中心经验。

Mid-term outcome of intracranial aneurysms treated with HydroSoft coils compared to historical controls treated with bare platinum coils: a single-center experience.

作者信息

Lee Jong Young, Seo Jeong Hwa, Lee Seung Jin, Son Young Je, Cho Young Dae, Kang Hyun-Seung, Han Moon Hee

机构信息

Department of Neurosurgery, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

出版信息

Acta Neurochir (Wien). 2014 Sep;156(9):1687-94. doi: 10.1007/s00701-014-2157-y. Epub 2014 Jul 1.

Abstract

BACKGROUND

HydroSoft (MicroVention, Aliso Viejo, CA), a hydrogel-platinum coil hybrid device, is one of various efforts to overcome recanalization of coiled intracranial aneurysms. The purpose of this study was to evaluate the efficacy and safety of the HydroSoft coils in patients with intracranial aneurysms, and to compare the 12-month outcomes with that of bare platinum coils.

METHODS

Four-hundred one patients harboring 430 intracranial aneurysms underwent endovascular embolization with the HydroSoft coils. In the control group, 221 patients harboring 253 aneurysms underwent coil embolization with bare platinum coils. The authors compared the degree of occlusion of the aneurysms, packing attenuations, procedural-related complications, and 12-month follow-up results between the two groups.

RESULTS

There were no significant differences of initial angiographic outcomes and procedure-related complications between the HydroSoft-coil group and the bare-coil group. Mean volumetric packing density of the HydroSoft-coil group was significantly higher than that of the bare platinum coil group (36.0 ± 8.50 % versus 32.1 ± 8.22 %, p < 0.001). The retreatment was performed in four (1.8 %) of 225 followed-up aneurysms among the HydroSoft coil group and 20 (8.8 %) of 227 followed-up aneurysms among the bare platinum coil group (p = 0.001, Fischer's exact test). Multivariate Poisson regression revealed that coil embolization using the HydroSoft coil significantly reduces the retreatment rate of coiled aneurysms at 12-month follow-up (adjusted RR, 0.21; 95 % CI, 0.07-0.64; p = 0.004).

CONCLUSION

Coil embolization using HydroSoft coils achieves higher volumetric packing density. Twelve-month follow-up data favors HydroSoft coils, with lower retreatment rates.

摘要

背景

HydroSoft(MicroVention公司,美国加利福尼亚州阿利索维耶霍)是一种水凝胶-铂金线圈混合装置,是为克服颅内动脉瘤弹簧圈栓塞后再通而做出的多种努力之一。本研究旨在评估HydroSoft弹簧圈治疗颅内动脉瘤患者的有效性和安全性,并将12个月的结果与裸铂金弹簧圈进行比较。

方法

401例患有430个颅内动脉瘤的患者接受了HydroSoft弹簧圈血管内栓塞治疗。在对照组中,221例患有253个动脉瘤的患者接受了裸铂金弹簧圈栓塞治疗。作者比较了两组之间动脉瘤的闭塞程度、填塞衰减、与手术相关的并发症以及12个月的随访结果。

结果

HydroSoft弹簧圈组和裸弹簧圈组在初始血管造影结果和与手术相关的并发症方面没有显著差异。HydroSoft弹簧圈组的平均体积填塞密度显著高于裸铂金弹簧圈组(36.0±8.50%对32.1±8.22%,p<0.001)。在HydroSoft弹簧圈组的225个随访动脉瘤中有4个(1.8%)进行了再次治疗,在裸铂金弹簧圈组的227个随访动脉瘤中有20个(8.8%)进行了再次治疗(p=0.001,Fisher精确检验)。多变量泊松回归显示,在12个月的随访中,使用HydroSoft弹簧圈进行弹簧圈栓塞显著降低了动脉瘤再次治疗的发生率(调整后的RR,0.21;95%CI,0.07-0.64;p=0.004)。

结论

使用HydroSoft弹簧圈进行弹簧圈栓塞可实现更高的体积填塞密度。12个月的随访数据显示HydroSoft弹簧圈更具优势,再次治疗率更低。

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