Guglielmi detachable coils versus matrix coils: a comparison of the immediate posttreatment results of the embolization of 364 cerebral aneurysms in 307 patients: a single-center, single-surgeon experience.

BACKGROUND: Matrix coils are based on Gugliemi detachable coils (GDC) but are covered with polyglycolic/polylactic acid. We present our experience regarding the immediate posttreatment results of aneurysm embolization using the 2 coil systems. PATIENTS: We embolized 219 aneurysms in 187 patients with the use of GDCs and 145 aneurysms in 120 patients with the use of Matrix coils. Age, sex distribution, unruptured aneurysm cases, and multiple aneurysm cases were similar in the 2 groups. The percentage of patients in severe clinical condition was significantly higher in the Matrix group. The mean aneurysm size was slightly larger in the GDC group but the mean neck size was larger in the Matrix group. RESULTS: Satisfactory occlusion (at least 90%) was achieved in 95.9% of GDC-treated aneurysms and in 98.6% of Matrix-treated aneurysms. Procedure-related complications occurred in 19.6% of GDC procedures and in 15.6% of the Matrix ones resulting in procedure-related mortality and morbidity of 3.7% and 2.7% for the GDC group and 2.5% and 1.7% for the Matrix group. In the GDC group, outcome was good (modified Rankin Scale 0-2) in 92.6% of patients with unruptured aneurysms, in 82.6% of patients with Hunt and Hess grade I-III, and in 20.5% of those with Hunt and Hess grade of IV-V. The respective figures were 95%, 85.7%, and 22.7% in the Matrix group. CONCLUSION: In our series, Matrix coils have yielded slightly better results regarding satisfactory occlusion rate and clinical outcome but these differences are not statistically significant and probably reflect our increased experience in aneurysm embolization during the period we used Matrix coils.

Embolization of acutely ruptured and unruptured wide-necked cerebral aneurysms using the neuroform2 stent without pretreatment with antiplatelets: a single center experience.

BACKGROUND AND PURPOSE: The Neuroform2 stent has been increasingly used in the stent-assisted coiling of wide-necked cerebral aneurysms, mostly after pretreatment with antiplatelet drugs. We retrospectively analyzed our results of stent-assisted coiling without pretreatment with antiplatelets. METHODS: We used 50 Neuroform2 stents in the treatment of 54 aneurysms without pretreatment with antiplatelets. Anticoagulation included intraprocedural heparin, nadroparin for 3 days, clopidogrel for 3 months, and aspirin for 6 months. RESULTS: Forty-nine stents were successfully deployed, and 52 of 54 aneurysms coiled (51 totally occluded and 1 subtotally). There was only one case of intraprocedural thrombus formation that was easily treated with recombinant tissue plasminogen activator. No serious hemorrhagic complications occurred during the follow-up period, and all 18 patients whose aneurysms have been controlled with angiography were found to have patent stents without stenosis and no aneurysm recanalization. No aneurysm rebleeding has occurred. CONCLUSION: We believe that stent-assisted coiling with the Neuroform2 stent is very effective and safe without pretreatment with antiplatelets in ruptured as well as in unruptured aneurysms.