Research ArticleLEVEL 1 EBM EXPEDITED PUBLICATION
Open Access
Hydrogel versus Bare Platinum Coils in Patients with Large or Recurrent Aneurysms Prone to Recurrence after Endovascular Treatment: A Randomized Controlled Trial
J. Raymond, R. Klink, M. Chagnon, S.L. Barnwell, A.J. Evans, J. Mocco, B.H. Hoh, A.S. Turk, R.D. Turner, H. Desal, D. Fiorella, S. Bracard, A. Weill, F. Guilbert, S. Lanthier, A.J. Fox, T.E. Darsaut, P.M. White and D. Roy
American Journal of Neuroradiology January 2017, DOI: https://doi.org/10.3174/ajnr.A5101
J. Raymond
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
R. Klink
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
M. Chagnon
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
S.L. Barnwell
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
A.J. Evans
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
J. Mocco
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
B.H. Hoh
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
A.S. Turk
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
R.D. Turner
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
H. Desal
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
D. Fiorella
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
S. Bracard
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
A. Weill
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
F. Guilbert
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
S. Lanthier
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
A.J. Fox
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
T.E. Darsaut
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
P.M. White
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
D. Roy
From the Departments of Radiology (J.R., A.W., F.G., D.R.) and Neurosciences (S.L.), Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada; Laboratory of Interventional Neuroradiology (R.K.), Research Centre of the Centre Hospitalier de l'Université de Montreal, Quebec, Canada; Department of Mathematics and Statistics (M.C.), Université de Montréal, Montreal, Quebec, Canada; Department of Neurological Surgery (S.L.B.), Oregon Health and Science University, Portland, Oregon; Department of Radiology and Medical Imaging (A.J.E.), University of Virginia, Charlottesville, Virginia; Department of Neurosurgery (J.M.), Mount Sinai Health System, New York, New York; Department of Neurosurgery (B.H.H.), University of Florida, Gainesville, Florida; Department of Neurosurgery (A.S.T., R.D.T.), Medical University of South Carolina, Charleston, South Carolina; Service de Neuroradiologie Diagnostique et Interventionnelle (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes, France; Cerebrovascular Center (D.F.), Stony Brook University Medical Center, Stony Brook, New York; Département de Neuroradiologie Diagnostique et Interventionnelle (S.B.), Centre Hospitalier Universitaire de Nancy, Nancy, France; Department of Medical Imaging (A.J.F.), University of Toronto, Toronto, Ontario, Canada; Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Edmonton, Alberta, Canada; and Stroke Research Group (P.M.W.), Institute of Neuroscience, Newcastle Upon Tyne, UK.
Abstract
BACKGROUND AND PURPOSE: Some patients are at high risk of aneurysm recurrence after endovascular treatment: patients with large aneurysms (Patients Prone to Recurrence After Endovascular Treatment PRET-1) or with aneurysms that have previously recurred after coiling (PRET-2). We aimed to establish whether the use of hydrogel coils improved efficacy outcomes compared with bare platinum coils.
MATERIALS AND METHODS: PRET was an investigator-led, pragmatic, multicenter, parallel, randomized (1:1) trial. Randomized allocation was performed separately for patients in PRET-1 and PRET-2, by using a Web-based platform ensuring concealed allocation. The primary outcome was a composite of a residual/recurrent aneurysm, adjudicated by a blinded core laboratory, or retreatment, intracranial bleeding, or mass effect during the 18-month follow-up. Secondary outcomes included adverse events, mortality, and morbidity (mRS > 2). The hypothesis was that hydrogel would decrease the primary outcome from 50% to 30% at 18 months, necessitating 125 patients per group (500 for PRET-1 and PRET-2).
RESULTS: The trial was stopped once 250 patients in PRET-1 and 197 in PRET-2 had been recruited because of slow accrual. A poor primary outcome occurred in 44.4% (95% CI, 35.5%–53.2%) of those in PRET-1 allocated to platinum compared with 52.5% (95% CI, 43.4%–61.6%) of patients allocated to hydrogel (OR, 1.387; 95% CI, 0.838–2.295; P = .20) and in 49.0% (95% CI, 38.8%–59.1%) in PRET-2 allocated to platinum compared with 42.1% (95% CI, 32.0%–52.2%) allocated to hydrogel (OR, 0.959; 95% CI, 0.428–1.342; P = .34). Adverse events and morbidity were similar. There were 3.6% deaths (1.4% platinum, 5.9% hydrogel; P = .011).
CONCLUSIONS: Coiling of large and recurrent aneurysms is safe but often poorly effective according to angiographic results. Hydrogel coiling was not shown to be better than platinum.
- © 2017 American Society of Neuroradiology
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J. Raymond, R. Klink, M. Chagnon, S.L. Barnwell, A.J. Evans, J. Mocco, B.H. Hoh, A.S. Turk, R.D. Turner, H. Desal, D. Fiorella, S. Bracard, A. Weill, F. Guilbert, S. Lanthier, A.J. Fox, T.E. Darsaut, P.M. White, D. Roy
Hydrogel versus Bare Platinum Coils in Patients with Large or Recurrent Aneurysms Prone to Recurrence after Endovascular Treatment: A Randomized Controlled Trial
American Journal of Neuroradiology Jan 2017, DOI: 10.3174/ajnr.A5101
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Hydrogel versus Bare Platinum Coils in Patients with Large or Recurrent Aneurysms Prone to Recurrence after Endovascular Treatment: A Randomized Controlled Trial
J. Raymond, R. Klink, M. Chagnon, S.L. Barnwell, A.J. Evans, J. Mocco, B.H. Hoh, A.S. Turk, R.D. Turner, H. Desal, D. Fiorella, S. Bracard, A. Weill, F. Guilbert, S. Lanthier, A.J. Fox, T.E. Darsaut, P.M. White, D. Roy
American Journal of Neuroradiology Jan 2017, DOI: 10.3174/ajnr.A5101
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