2012 年 6 巻 2 号 p. 87-97
Objectives: The HydroSoft and HydroFrame coils are a new generation of coils designed to further improve the safety and durability of aneurysm coiling using hydrogel technology. The authors report their experience using the HydroSoft and HydroFrame coils for the treatment of intracranial aneurysms.
Methods: Immediate and follow-up angiographic results, procedure-related complications, and retreatments were retrospectively analyzed for 106 intracranial saccular aneurysms in 103 patients treated with the HydroSoft and HydroFrame coils during a 50-month period.
Results: The incidence of thromboembolic complications was 5.7%. Procedure-related morbidity and mortality rates were each 0.9%. None of the patients with unruptured aneurysms developed hydrocephalus. Immediate post-procedure angiograms showed complete aneurysm occlusion in 34.9% of cases, neck remnant in 36.8%, and incomplete occlusion in 28.3%. Angiographic follow-up was obtained in 51.9% (55 of 106 aneurysms; average, 16 months; range, 6-45 months). In these 55 aneurysms, the rate of immediate complete occlusion was 27.3% after treatment, which increased to 50.9% on follow-up, and the overall recanalization rate was 14.5%. No recanalization was observed in the 8 aneurysms treated with stent-assisted coiling in combination with HydroSoft and HydroFrame coil placement.
Conclusions: The overall safety profile of the HydroSoft and HydroFrame coils appears to be acceptable. Preliminary midterm observation suggests that these new-generation hydrogel coils will improve the durability of angiographic occlusion, when compared with immediate post-embolization results, and can reduce the rate of aneurysm recanalization.