New extremely soft bare platinum coil is a safe and effective endovascular treatment for cerebral aneurysms

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The first use of a new extremely soft bare platinum coil has been reported in a study led by Kei Harada, Department of Neurovascular Surgery, Fukuoka Wajiro Hospital and Neuro-Vascular Center, Fukuoka, Japan, and published in the Journal of NeuroInterventional Surgery

Treatment with coils, according to the authors, is a safe and less invasive than surgical clipping for the treatment of cerebral aneurysms, however there have been cases, in the past, at long-term follow-up, where the compaction of the coil ball or regrowth or recanalisation of the aneurysm has occurred. Therefore the authors aimed to assess the efficacy, safety and clinical performance of the extremely soft bare platinum coil for embolization of cerebral aneurysms using packing density as an indicator.

In order to achieve this, data from 92 aneurysms in 89 patients were analysed retrospectively. The EDC-10 ES (Kaneka Medix) was the coil used as a representative for the extremely soft bare platinum coil and the suitability of the patients for coiling treatment was decided by neurosurgeons and neurointerventionalists or if the patient refused clipping. According to the authors, 34 (37%) of the aneurysms were unruptured and 58 (63%) were ruptured with severe neurological condition (4–5 on the World Federation of Neurological Societies grade).

The mean volume of the 92 aneurysms was 131.3±171.6mm3, the mean±SD volume was 6.5±2.8mm, the aneurysm diameter was 5.8±2.4mm and dome and neck size was 3.3±1.4mm.

Harada et al stated that 41 of the embolizations were performed with simple techniques and, 51 with an adjunctive technique (of which 42 included the balloon-assist technique and 9 included the double catheter technique).

In the study it was said that the mean packing density was 29.5±10.6% and the mean±SD percentage EDC-10 ES volume was 40.5%±25.1%. The degree of occlusion was measured using the modified three-point Raymond score (RS). Initial angiographic results showed that the sac and the neck were occluded completely in 63 of the aneurysms (RS1). Complete occlusion was not achieved in 29 aneurysms graded at RS2 and in 18 RS3 cases. The authors said that these results indicate a favourable packing density and recanalisation rate and is therefore a good treatment, in the long-term, for cerebral aneurysms.

“Coil embolization is widely accepted as a safe and effective treatment for the treatment of cerebral aneurysms,” said Harada and colleagues. “These results show that improvement in the mechanical properties of embolization coils produces desirable effects on handling properties and contributes to a better outcome.”

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