Polyglycolide/polylactide-coated platinum coils for patients with ruptured and unruptured cerebral aneurysms: a single-center experience

Stroke. 2005 Sep;36(9):1948-53. doi: 10.1161/01.STR.0000177532.94736.85. Epub 2005 Jul 28.

Abstract

Background and purpose: Recanalization of cerebral aneurysm is a limitation of bare platinum coils (BPCs). In a swine aneurysm model, polyglycolide/polylactide (a polymer)-coated platinum coils (Matrix) accelerated clot fibrosis and reduced recanalization rate and aneurysmal volume. We aimed to evaluate the safety of Matrix coils in patients with intracranial aneurysm.

Methods: This is a single-center, prospective study of patients with intracranial aneurysms treated with Matrix alone or in combination with BPCs. Follow-up evaluation included a 1-month clinical evaluation and a 6- and 12-month clinical and angiographic examination. Primary adverse events included death, stroke, and permanent neurological deficits.

Results: Between May 2002 and January 2004, 52 patients (range 34 to 79 years of age; 38 females) were treated for 54 aneurysms (size 7.9+/-4.6 mm; neck 3.9+/-1.5 mm; 26 ruptured). Matrix alone was used in 13 aneurysms. In 39, we used a combination of Matrix and BPCs. Twenty-one aneurysms had a 6-month follow-up examination (11 Matrix; 10 Matrix combined with bare platinum), and 11 completed the 12-month follow-up evaluation (Matrix only). Adverse events not related to the procedure were 2 deaths (ruptured basilar aneurysms) and 1 stroke at day 10 postcoiling secondary to vasospasm. Procedure-related adverse events were 2 strokes. At 6-month follow-up (n=21) evaluation, 2 of 3 recanalizations needed retreatment. At 12-month follow-up (n=11), there was no recanalization in patients treated with Matrix alone and no significant reduction in aneurysmal size.

Conclusions: Polyglycolide/polylactide-coated coils had a satisfactory safety profile. Significant aneurysmal size reduction after coiling was not observed.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured / therapy*
  • Biocompatible Materials / chemistry*
  • Cerebral Angiography / methods
  • Cohort Studies
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation
  • Intracranial Aneurysm / pathology*
  • Male
  • Middle Aged
  • Pilot Projects
  • Polyesters / chemistry*
  • Polyglycolic Acid / chemistry*
  • Polymers / chemistry
  • Prospective Studies
  • Recurrence
  • Time Factors
  • Treatment Outcome

Substances

  • Biocompatible Materials
  • Polyesters
  • Polymers
  • Polyglycolic Acid
  • poly(lactide)