使用聚乙醇酸/聚乳酸镀膜铂金属圈治疗破裂或未破裂的脑动脉瘤患者:一项单中心试验

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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 1month 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. 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 1month 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 In 39, we used a combination of Matrix and BPCs. Twenty-one ane was treated for 54 aneurysms (size 7.9 ± 4.6 mm; neck 3.9 ± 1.5 mm; 26 ruptured) urysms 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.
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