The impact of first and second generation Hydrogel Coil Technology on Cerebral Aneurysm Treatment: A single practice experience

INTRODUCTION: Bare platinum coils have demonstrated safety and efficacy in the treatment of intracranial aneurysms; however, a persistent and important limitation occurs in the form of delayed recanalisation. The authors report their multiple-hospital, single-practice experience with the use of first and second-generation hydrogel coils for the treatment of ruptured and unruptured cerebral aneurysms. METHODS: During a period of 44 months, 101 consecutive patients with 104 ruptured or unruptured intracranial aneurysms were treated by a two-physician team covering several hospitals. Hydrogel coils, both first (Hydrocoil®) and second (HydroFrame®, HydroFill® and HydroSoft®) generation, were exclusively used in this patient cohort. Retrospective analysis of clinical and angiographic data was performed. RESULTS: Procedural morbidity and mortality were 5 % and 0 % respectively. No patient developed hydrocephalus or aseptic meningitis. The rates of immediate post-procedure total occlusion were 94 %, of neck remnants 6 % and incomplete occlusion 0 %. Long-term (>12 months) angiographic follow-up was obtained in 95 patients (94 %). No recanalisations were observed in any of those patients, whether treated with stent-assisted coiling, balloon assisted coiling or with coils only, including patients who had presented with recurrent, recanalised aneurysms. CONCLUSION: In our patient population, the safety profile of Hydrogel coils was found to be similar to that of non-coated platinum coils. Moreover, significantly improved obliteration rates, both early and delayed, were observed in our patient population, possibly from enhanced long-standing separation of the intra-aneurysmal environment from the parent artery.