Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지

Angiographic Follow-up Result of Cerebral Aneurysms Treated with Coils Covered with Polyglycolic-Polylactic Acid Copolymer

  • Kim, In-Cheol (Department of Neurological Surgery, Gil Medical Center, Gacheon Medical School) ;
  • Chun, Young-Il (Department of Neurological Surgery, Gil Medical Center, Gacheon Medical School) ;
  • Park, Cheol-Wan (Department of Neurological Surgery, Gil Medical Center, Gacheon Medical School) ;
  • Park, Chan-Woo (Department of Neurological Surgery, Gil Medical Center, Gacheon Medical School) ;
  • Lee, Uhn (Department of Neurological Surgery, Gil Medical Center, Gacheon Medical School)
  • Published : 2006.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : We evaluate the effect of the copolymer-coated coils on immediate occlusion of the aneurysm, preventing rupture, and decreasing compaction or re-growth. Methods : Thirty-five aneurysms treated between September 2003 and December 2004 using Matrix detachable coil were reviewed. Study population consisted of 12 men and 23 women ranging in age from 34 to 75 years[mean, 55.1 years]. Twenty-two aneurysms were ruptured and 23 aneurysms were located in the anterior circulation. Follow-up angiography was obtained in 16 patients after 6 months from the procedure. Results : Initial complete occlusion was achieved in 17 aneurysms[48.6%], and the others remained as a residual neck in 8 aneurysms[22.8%] and residual sac in 10 aneurysms[28.6%]. Among these incompletely occluded aneurysms, 7 aneurysms were performed follow-up angiography. And 6 of them converted into complete occlusion. In the other hands, among 17 aneurysms achieved complete occlusion initially, 9 aneurysms were performed follow-up angiography. Recurrence due to coil compaction occurred in one aneurysm and the others maintained complete occlusion. There was one mortality case due to thromboembolic complication. Conclusion : In spite of difficulty in achieving complete occlusion with Matrix coil system, there is no rupture or re-rupture during follow-up period. Follow-up angiography shows many conversions of residual sac into complete occlusion. Embolization using Matrix coil system is safe and effective, but the effects of PGLA copolymer need further investigation.

Keywords

References

  1. Abrahams JM, Forman MS, Grady MS, Diamond SL : Delivery of human vascular endorhelial growrh factor wirh platinum coils enhances wall rhickening and coil impregnation in a rat aneurysm model. AJNR Am J Neuroradiol 22: 1410-1417, 2001
  2. Bavinzski G, Talazoglu V, Killer M, Richling B, Gruber A, Gross CE, et al : Gross and microscopic histopathological findings in aneurysms of rhe human brain treated with Guglielmi detachable coils. J Neurosurg 91: 284-293, 1999 https://doi.org/10.3171/jns.1999.91.2.0284
  3. Castro E, Fortea F, Villoria F, Lacruz C, Ferreras B, Carrillo R : Longterm histoparhologic findings in two cerebral aneurysms embolized with Guglielmi detachable coils. AJNR Am J Neuroradiol 20: 549-552, 1999
  4. Dawson RC III, Shengelaia GG, Krisht AF, Bonner GD : Histologic effects of collagen-filled interlocking detachable coils in rhe ablation of experimental aneurysms in swine. AJNR Am J Neuroradiol 17 : 853-858, 1996
  5. Debrun GM, Aletich VA, Kehrli P, Misra M, Ausman JI, Charbel F : Selection of cerebral anewysms for treatment using Guglielmi detachable coils: the preliminary University of Illinois at Chicago experience. Neurosurgery 43: 1281-1295; discussion 1296-1297, 1998 https://doi.org/10.1097/00006123-199812000-00011
  6. de Gast AN, Altes TA, Marx WF, Do HM, Helm GA, Kallmes DF : Transforming growth factor beta-coated platinum coils for endovascular treatment of anewysms : an anirnal study. Neurosurgery 49 : 690-694, 2001 https://doi.org/10.1097/00006123-200109000-00030
  7. Ding YH, Dai D, Lewis DA, Cloft HJ, Kallmes DF : Angiographic and histologic analysis of experimental aneurysms embolized with platinum coils, Matrix, and HydroCoil. AJNR Am J Neuroradiol 26 : 1757-1763, 2005
  8. Freed LE, Vunjak-Novakovic G, Biron RJ, Eagles DB, Lesnoy DC, Barlow SK, et al : Biodegradable polymer scaffolds for tissue engineering. Biotechnology 12: 689-693, 1994 https://doi.org/10.1038/nbt0794-689
  9. Horowitz MB, Purdy PD, Bums D, Bellotto D : Scanning electron microscopic findings in a basilar tip aneurysm embolized with Guglielmi detachable coils. AJNR Am J Neuroradiol 18: 688-690, 1997
  10. Kiyosue H, Tanoue S, Okahara M, Hori Y, Nakamura T, Nagatomi H, et al : Anatomic features predictive of complete aneurysm occlusion can be determined with three-dimensional digital subtraction angiography. AJNR Am J Neuroradiol 23: 1206-1213, 2002
  11. Koizumi T, Kawano T, Kazekawa K, Kawaguchi T, Honma T, Kaneko Y, et al : Histological findings in aneurysm treated with IDC : scanning electron microscopical study. No Shinkei Geka 25 : 1027-1031, 1997
  12. Linfante I, Akkawi NM, Perlow A, Andreone V, Wakhloo AK: Polyglycolide/Polylactide-Coated Platinum Coils for Patients With Ruptured and Unruprured Cerebral Aneurysms, A Single-Center Experience. Stroke 36 : 1948-1953, 2005 https://doi.org/10.1161/01.STR.0000177532.94736.85
  13. Marx WE, Cloft HJ, Helm GA, Shon JG, Do HM, Jensen ME, et al: Endovascular treatment of experimenral aneurysms by use of biologically modified embolic devices: coil-mediated intraaneurysmal delivery of fibro-blast tissue allografts. AJNR Am J Neuroradiol 22: 323-333, 2001
  14. Mawad ME, Mawad JK, Carrwright J Jr, Gokaslan Z: Long-term histopathologic changes in canine anewysms embolized with Guglielmi detachable coils. AJNR Am J Neuroradiol 16: 7-13, 1995
  15. Mizoi K, Yoshimoto T, Takahashi A, Nagamine Y: A pitfall in the surgery of a recurrent aneurysm after coil embolization and its histological observation: technical case teport. Neurosurgery 39: 165-168, 1996 https://doi.org/10.1097/00006123-199607000-00035
  16. Molyneux AJ, Ellison DW, Morris J, Byrne JV : Histological findings in giant aneurysms treated with Guglielmi detachable coils: report of two cases with autopsy correlation. J Neurosurg 83 : 129-132, 1995 https://doi.org/10.3171/jns.1995.83.1.0129
  17. Murayama Y, Tateshima S, Gonzalez NR, Vinuela F: Matrix and bioabsorbable polymeric coils accelerate healing of intracranial aneurysms: long-term experimental study. Stroke 34: 2031-2037, 2003 https://doi.org/10.1161/01.STR.0000083394.33633.C2
  18. Murayarna Y, Vinuela F, Suzuki Y, Do HM, Massoud TF, Guglielmi G, et al : Ion implantation and protein coating of detachable coils fot endovascular treatment of cerebral anewysms : concepts and preliminary results in swine models. Neurosurgery 40 : 1233-1244, 1997 https://doi.org/10.1097/00006123-199706000-00024
  19. Murayarna Y, Vinuela F, Tateshima S, Gonzalez NR, Song JK, Mahdavieh H, et al : Cellular responses of bioabsorbable polymeric matetial and Guglielmi detachable coil in experimental anewysms. Stroke 33 : 1120-1128, 2002 https://doi.org/10.1161/01.STR.0000014423.20476.EE
  20. Park JC, Kim JE, Oh CW, Han DH: Cerebral aneurysms by using the Guglielmi detachable coils. J Korean Neurosurg Soc 34: 187-191, 2003
  21. Raymond J, Desfaits AC, Roy D : Fibrinogen and vascular smooth muscle cell grafts promote healing of experimental aneurysms treated by embolization. Stroke 30: 1657-1664, 1999 https://doi.org/10.1161/01.STR.30.8.1657
  22. Stiver Sl, Potter PJ, Willinsky RA, Wallace MC: Acute human histopathology of an intracranial aneurysm treated using Guglielmi detachable coils: case report and review of the literature. Neurosurgery 43 : 1203-1208, 1998 https://doi.org/10.1097/00006123-199811000-00106
  23. Szikora I, Wakhloo AK, Guterman LR, Chavis TD, Dawson RC III, Hergenrother RW, et al : Initial experience with collagen-filled Guglielmi detachable coils for endovascular treatment of experimental aneurysms. AJNR Am J Neuroradiol 18 : 667-672, 1997
  24. Tarnatani S, Ozawa T, Minakawa T, Takeuchi S, Koike T, Tanaka R: Histological interaction of cultured endothelial cells and endovascular embolic materials coated with extracellular matrix. J Neurosurg 86 : 109-112, 1997 https://doi.org/10.3171/jns.1997.86.1.0109
  25. Tenjin H, Fushiki S, Nakahara Y, Masaki H, Matsuo T, Johnson CM, et al : Effect of Guglielmi detachable coils on experimental carotid artery aneurysms in primates. Stroke 26: 2075-2080, 1995 https://doi.org/10.1161/01.STR.26.11.2075
  26. Vallee JN, Pierot L, Bonafe A, Turjman F, Flandroy P, Berge J, er al : Endovascular treatment of intracranial wide-necked aneurysms using threedimensional coils: predictors of immediate anatomic and clinical results. AJNR Am J Neuroradiol 25 : 298-306, 2004