HydroSoft coil versus HydroCoil for endovascular aneurysm occlusion study: A single center experience

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Abstract

Background and purpose

The HydroCoil Embolic System (HES) was developed to reduce recurrences of aneurysms relative to platinum coils. But the HydroCoil Embolic System was characterized with many limitations. The manufacturer had recognized the challenge and recently a new design of hydrogel-coated coil—HydroSoft has become available in the market as the new generation HydroCoil. We reported our initial experience using HydroSoft coil versus HydroCoil in our center.

Methods

75 aneurysms embolized primarily using HydroSoft Coils from July 2008 to May 2009 were compared with 66 volume- and shape-matched aneurysms treated with HydroCoils from March 2006 to August 2008. Outcome measures included length and number of coils used, contrast volume, and length of hospital stay. During embolization, a stable framework was first established with bare coils, and hydrogel-coated coils were used subsequently to increase the packing density. Follow-up angiographic results 6 months after treatment were evaluated among some of the patients.

Results

Successful coil embolization was achieved in all patients. There were no differences in average total coil length used per aneurysm. There were no differences in length of hospital stay and packing density. HydroSoft coils were more suitable using as the finishing or final coil. HydroSoft coil decreased the procedure-related retreated rates, and aneurysm packing was finished with soft, flexible HydroSoft coil and decreased the neck remnant rates. Follow-up angiography in HydroSoft-treated patients at 6 months revealed aneurysm stability without significant residual neck.

Conclusions

HydroSoft coil allowed us to deploy coated coils with good packing density. A slight expansion of these coils at the neck can be expected to reduce neck remnant and potentially inhibit recurrence.

Section snippets

Materials and methods

Patients and techniques 75 consecutive aneurysms in 73 patients were treated retrospectively using Hydrosoft coils between July 2008 and May 2009. 66 consecutive aneurysms in 64 patients were treated using HydroCoils between March 2006 and August 2008. Aneurysm presentations included all clinical grades of acute subarachnoid hemorrhage and unruptured aneurysms. Aneurysms were situated in a variety of locations in the anterior and posterior circulations and were of various sizes.

Embolization of

Embolization procedure

Each embolization procedure was performed in a digital angiographic suite by using standard techniques. A series of coils of appropriate dimensions will be selected and placed into the aneurysm by using an angiographic road map where appropriate. One or more 3D platinum coils were generally used to establish the initial framework in the aneurysm lumen and form a multiplanar structure for subsequent HydroCoils or HydroSoft coils deposition. Angiograms were taken immediately after the last coil

Patients and aneurysms

75 HydroSoft-treated aneurysms in 73 patients were eligible for the study. 66 HydroCoil-treated aneurysms in 64 patients were treated. Aneurysms included were located in a wide variety of locations in both the anterior and posterior circulation. Balloon remodeling (Fig. 3) and adjunctive stent placement (Fig. 4) were used in suitable cases. Intraprocedural rupture occurred in no case HydroSoft-treated aneurysm and 3 HydroCoil-treated aneurysms of ruptured aneurysm patients and no cases of

Discussion

We reported our initial experience with HydroSoft coils used as the primary packing for aneurysms in comparison to HydroCoils. The packing attenuation (a mean 47%) achieved in HydroSoft-treated cohort was somewhat higher than what has been achieved in HydroCoil-treated cohort (a mean 38%). A total of 39 HydroCoils wasted because we failed to deploy them related to the time limitation and HydroCoils became useless. We think there are two reasons: first, HydroCoils were too stiffer to deploy

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1

Tel.: +86 22 60363760; fax: +86 22 60362386.

2

Prof. Jian-ning Zhang and Prof. Yi-mu Fan are equal on the published article.

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