Matrix detachable coils for the endovascular treatment of intracranial aneurysms: analysis of early angiographic and clinical outcomes.

摘要

BACKGROUND AND PURPOSE: Endovascular coil embolization has become an accepted alternative for the treatment of intracranial aneurysms. The purpose of this study was to evaluate the clinical safety and the angiographic stability of aneurysm occlusion with a new class of biologically active platinum coils after a 6-month period. METHODS: Twenty-five patients with 25 intracranial aneurysms were treated by selective embolization with a new coated bioactive coil (Matrix; Boston Scientific Neurovascular). Matrix coils were used alone in 6 patients and in combination with Guglielmi detachable coils (GDCs; Boston Scientific Neurovascular) in 19. Angiographic results, procedure-related complications, and adverse neurological events during the follow-up period were recorded. Magnetic resonance angiography was performed at 6 months in all patients. RESULTS: Initial angiographies demonstrated complete occlusion in 17 patients, residual neck in 7, and a persisting aneurysm in 1. The clinical follow-up showed stableresults in all patients. The grade of aneurysm occlusion at 6 months improved in 4 patients, remained stable in 15, and deteriorated in 6. Three patients needed retreatment because of a major aneurysm recanalization. Angiographic recurrences in cases of aneurysms treated with a combination of Matrix coils and GDCs occurred within the expected range for bare platinum coils. Two of 3 patients needing retreatment had been treated with Matrix coils alone. CONCLUSIONS: Stable results were obtained predominantly when Matrix coils were combined with bare platinum coils. A prospective, randomized study is necessary to assess the potential benefit of Matrix coils for patients treated by endovascular techniques.