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This prospective, randomized, multicenter study compares the efficacy of the Matrix versus bare metal coils. A group of 626 patients were divided between the 2 coil types and aneurysm recurrence and hemorrhage were assessed 1 year after procedures. Recurrences were associated with initial incomplete obliterations and the bare metal coils were not inferior to Matrix coils. Thus, due to cost differences, utilization of Matrix coils may not be justified.

Controversy about the best treatment method for MCA aneurysms persists and these authors report the results of endovascular treatment of these lesions in a large series in which 295 such aneurysms were treated during a 17-year period and the results retrospectively analyzed. Complete occlusion was achieved in 94% and treatment failed in 4.3%. Procedure-related morbidity and mortality occurred in nearly 8%. Death occurred in 13.6% of patients and 4.3% needed to be re-treated. Thus, endovascular treatment of MCA aneurysms is acceptable as a primary treatment.

These authors analyzed data on 131 non-selected MCA aneurysms treated during a 6-year period. One month after treatment, permanent morbidity and mortality was 3.3% without significant differences according to technique used. The rate of recanalization was nearly 16%, also without differences according to technique, and re-treatment was needed in 7.6% of cases. A greater rate of complications occurred with balloon remodeling and only large aneurysm size predicted recanalization. The authors concluded that endovascular treatment of MCA aneurysms is safe, effective, and durable.