Use of a First Large-Sized Coil Versus Conventional Coils for Embolization of Cerebral Aneurysms: Effects on Packing Density, Coil Length, and Durable Occlusion.

Authors:
Kun Zhang
Kun Zhang
College of Life Sciences
China
Zi-Liang Wang
Zi-Liang Wang
Henan University
China
Ying-Kun He
Ying-Kun He
School of Environmental Science and Engineering
Chapel Hill | United States

World Neurosurg 2019 Jul 1;127:e685-e691. Epub 2019 Apr 1.

Henan Provincial Cerebrovascular Hospital, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.

Objective: To investigate effects of using a large-sized coil first on embolizing cerebral aneurysms compared with conventional coils.

Materials And Methods: Forty-six patients with 51 saccular intracranial aneurysms who underwent embolization with a large-sized coil first were enrolled as the large-sized coil group. There were 33 female and 13 male patients with a mean age of 56.9 ± 8.8 years. The treatment modality was coiling alone in 30 aneurysms and stent-assisted coiling in 21. Meanwhile, 50 patients with 53 intracranial aneurysms who were treated with conventional-sized coils were selected as the control conventional-sized coil group, including 36 female and 14 male patients with a mean age of 54.6 ± 5.8 years. The treatment modality was coiling alone in 29 aneurysms and stent-assisted coiling in 24 aneurysms. The occlusion rate, percent packing volume, total coil number and length, and follow-up occlusion rate were compared between the 2 groups.

Results: Significantly (P < 0.001) decreased percent packing volume (19.54% ± 6.44% vs. 27.39% ± 5.68%), decreased coil number (2.98 ± 1.09 vs. 6.38 ± 1.65), and length (26.20 ± 26.57 vs. 44.35 ± 35.88 cm) were achieved in the large versus the conventional coil group. At angiographic follow-up of 8 months, only 1 aneurysm (2.2%) recurred in the large coil group compared with 5 aneurysms recurrent (11.1%) in the conventional coil group.

Conclusions: The use of a large-sized coil as the first one for embolizing cerebral aneurysms may be a better embolization strategy because it achieves similar initial occlusion rates, decreased packing density, decreased coil numbers and lengths, and reduced recurrence prevalence at follow-up.

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http://dx.doi.org/10.1016/j.wneu.2019.03.242DOI Listing

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July 2019
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