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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleNeurointervention

Short-Term Outcome of Intracranial Aneurysms Treated with Polyglycolic Acid/Lactide Copolymer–Coated Coils Compared to Historical Controls Treated with Bare Platinum Coils: A Single-Center Experience

Hyun-Seung Kang, Moon Hee Han, Bae Ju Kwon, O-Ki Kwon, Sung Hyun Kim, Seung Hong Choi and Kee-Hyun Chang
American Journal of Neuroradiology September 2005, 26 (8) 1921-1928;
Hyun-Seung Kang
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Moon Hee Han
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Bae Ju Kwon
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O-Ki Kwon
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Sung Hyun Kim
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Seung Hong Choi
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Kee-Hyun Chang
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    Fig 1.

    Complete occlusion. Pre-embolization angiogram (A) and postembolization angiogram (B). Complete occlusion was achieved in the anterior communicating aneurysm of a 62-year-old woman. This unruptured aneurysm measured 8.2 mm × 6.0 mm × 6.8 mm. A total of 19 coils (136 cm) were deployed, of which 13 (116 cm) were PGLA-coated. Packing attenuation was calculated to be 68%.

    Near-complete occlusion. Pre-embolization angiogram (C) and postembolization angiogram (D). Near-complete occlusion was achieved in the basilar top aneurysm of a 38-year-old man, presenting with subarachnoid hemorrhage. This aneurysm measured 12.8 mm × 10.2 mm × 10.9 mm. A total of 11 coils (185 cm) were deployed, of which 6 (105 cm) were PGLA-coated. Tiny contrast-filled spaces are seen near neck of the aneurysm. Packing attenuation was calculated to be 19%.

  • Fig 2.
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    Fig 2.

    Minor recanalization. Pre-embolization angiogram (A), postembolization angiogram (B), and control angiogram at 12 months postembolization (C). Near-complete occlusion was achieved in the unruptured internal carotid artery aneurysm of a 61-year-old woman (B). Follow-up angiogram (C) shows minimal recanalization of the aneurysm neck with compaction of the coil mesh (arrow).

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    Fig 3.

    Major recanalization. Pre-embolization angiogram (A), postembolization angiogram (B), and control angiogram at 7 months postembolization (C). Complete occlusion was achieved in the ruptured anterior communicating artery aneurysm of a 35-year-old man (B). Follow-up angiogram (C) shows significant recanalization of the aneurysm; coil mesh is compacted into the dome of aneurysm and loosened at its upper aspect (arrow).

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    Fig 4.

    Relationship between coil volumes and aneurysm volumes. Graph shows a linear relationship between the aneurysm volumes and the coil volumes in either group. Coil volume and aneurysm volume are expressed in logarithmic scales. Overall spots of the PGLA-coil group are located higher than those of control group.

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    Fig 5.

    Relationship between packing densities and aneurysm volumes. Graph shows an inverse relationship between the aneurysm volumes and the packing densities in either group. Aneurysm volume is expressed in a logarithmic scale. Overall spots of the PGLA-coil group are located higher than those of control group.

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    Fig 6.

    Paths of follow-up in PGLA-coil group (A) and bare-coil group (B). There are no significant differences in the recanalization rates between two groups. CA, conventional angiography.

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    Fig 7.

    Recanalization rate according to packing attenuation group in PGLA-coil group (A, P = .0016) and bare-coil group (B, P = .0837). Gray bars represent percentages of aneurysms showing recanalization and white bars those showing stable occlusion at follow-up imaging. With increasing packing densities less percentage of aneurysms become recanalized in either group (χ2 test for trend).

Tables

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    TABLE 1:

    Group characteristics

    PGLA Coil GroupBare Coil GroupP
    Total no. of cases56 An (51 Pt)87 An (78 Pt)NA
    Sex (M:F)16:3532:46.3562
    Age (mean ± SD)53.8 ± 12.256.4 ± 11.9.2319
    Aneurysm
        Ruptured1941.1653
        Unruptured3746
    ≥10 mm diam.1112.4863
    <10 mm diam.4575
    ≥100 mm3 vol (≥600 mm3)23 (3)26 (4).5326
    <100 mm3 vol3350
    • Note.—An indicates aneurysms; Pt, patients.

    • View popup
    TABLE 2:

    Comparison of volumes of aneurysms and coils deployed and packing densities between the two groups

    PGLA coil(n = 56)Bare Platinum Coil(n = 77)P
    Aneurysm volume222 ± 459181 ± 403.4794*
    Coil volume46.5 ± 81.428.4 ± 53.3.0026*
    Packing density30.9 ± 13.321.4 ± 7.6<0.0001†
    • * Mann–Whitney test.

    • † Unpaired Student t-test.

    • View popup
    TABLE 3:

    Linear regression analyses for logs of aneurysm volumes and logs of coil volumes

    ParameterPGLA CoilBare Platinum Coil
    Pearson r0.9563 (95% CI: 0.9280, 0.9737)0.9684 (95% CI: 0.9506, 0.9798)
    r20.91460.9377
    Slope0.7223 (95% CI: 0.7064, 0.7383)0.6451 (95% CI: 0.6296, 0.6605)
    • View popup
    TABLE 4:

    Differences of packing densities in subgroups according to percentage length of PGLA coils

    % LengthnMean Packing DensityP*
    <25519.0 ± 4.5NA
    2130.1 ± 11.7.0118
    1734.5 ± 15.1.0293
    1332.9 − 13.9.0093
    • * Mann–Whitney U-test, compared with the first group (ie, % length <25).

    • View popup
    TABLE 5:

    Cases showing major recanalization in the PGLA-coated coil group

    Patient No./Age (y)/SexH-HLoc.Size (mm)PD (%)% PGLAInterval (mo)
    13/66/F0ICA10.4 × 7.8 × 7.029.0705
    15/35/MIACoA7.6 × 6.1 × 5.417.7376
    24/62/F0ACoA9.3 × 6.2 × 6.518.6286
    36/63/M0BA15.0 × 8.6 × 6.217.7594
    42/47/F0ICA5.2 × 5.0 × 5.335.21001
    • Note.—H-H indicates Hunt and Hess grade; Loc., location of aneurysm; Size, size of aneurysm; PD, packing density; % PGLA, % length of PGLA coils among total coils deployed; Interval, interval from coil embolization to diagnosis of aneurysm recanalization.

    • View popup
    TABLE 6:

    Recanalization rate according to percentage length of PGLA coils deployed

    Criterionn*Major Recanal,No. (%)P†Total Recanal,No. (%)P†
    Below17/262 (12)2 (12)
    50%1.0000.0173
    Above22/303 (14)11 (50)
    Below28/434 (14)8 (29)
    75%1.0000.2293
    Above9/131 (11)5 (56)
    • * Number of cases with follow-up imaging studies/number of total cases.

    • † Fisher exact test.

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American Journal of Neuroradiology: 26 (8)
American Journal of Neuroradiology
Vol. 26, Issue 8
1 Sep 2005
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Short-Term Outcome of Intracranial Aneurysms Treated with Polyglycolic Acid/Lactide Copolymer–Coated Coils Compared to Historical Controls Treated with Bare Platinum Coils: A Single-Center Experience
Hyun-Seung Kang, Moon Hee Han, Bae Ju Kwon, O-Ki Kwon, Sung Hyun Kim, Seung Hong Choi, Kee-Hyun Chang
American Journal of Neuroradiology Sep 2005, 26 (8) 1921-1928;
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Hyun-Seung Kang, Moon Hee Han, Bae Ju Kwon, O-Ki Kwon, Sung Hyun Kim, Seung Hong Choi, Kee-Hyun Chang
Short-Term Outcome of Intracranial Aneurysms Treated with Polyglycolic Acid/Lactide Copolymer–Coated Coils Compared to Historical Controls Treated with Bare Platinum Coils: A Single-Center Experience
American Journal of Neuroradiology Sep 2005, 26 (8) 1921-1928;

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