Hydrogel versus Bare Platinum Coils in Patients with Large or Recurrent Aneurysms Prone to Recurrence after Endovascular Treatment: A Randomized Controlled Trial

Raymond, Jean; Klink, Ruby; Chagnon, Miguel; Barnwell, Stanley L.; Evans, Avery J.; Mocco, J; HOh, B; Turk, Aquilla S; Turner, Raymond D; Desal, Hubert; Fiorella, D.; Bracard, Serge; Weill, Alain; Guilbert, F; Lanthier, Sylvain; Fox, Allan J.; Darsaut, T.E.; White, Phil; Roy, Daniel

doi:10.3174/ajnr.a5101

Cited by 33 publications

(35 citation statements)

References 35 publications

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“…All 4 RCTs [ 16 , 17 , 19 , 21 ] enrolling 1526 patients were pooled for the analysis of periprocedural and mid-term outcome respectively from two aspects of efficacy and safety.…”

Section: Resultsmentioning

confidence: 99%

“…In 2018, GREAT(German-French Randomized Endovascular Aneurysm Trial) was established, and some researchers found that compared to bare platinum coils, hydrogel coils decrease the rate of unfavorable outcome events, recurrence, retreatment, morbidity mortality, and need for retreatment in small- and medium-sized intracranial aneurysms [ 19 , 20 ]. Containing both types of hydrogel coils, PRET 2017(Patients prone to Recurrence after Endovascular Treatment) illustrated that there were no significant differences between hydrogel coils group and bare platinum coils group [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Hydrogel coils versus bare platinum coils for the endovascular treatment of intracranial aneurysms: a meta-analysis of randomized controlled trials

et al. 2018

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BackgroundRecent studies have shown conflicting results regarding the effect of hydrogel coils for treating intracranial aneurysm compared to bare platinum coils. We implemented a meta-analysis to assess the value of hydrogel coils in intracranial aneurysm treatment.MethodsThe MEDLINE, EMBASE, and Cochrane Library databases were searched for randomized controlled trials (RCTs) which had evaluated hydrogel coils versus bare platinum coils for intracranial aneurysms.ResultsWe pooled 1526 patients from 4 RCTs with the mean follow-up time of more than 16 months. Hydrogel coils had reductions on mid-term recurrence (RR 0.78, 95% CI 0.65 to 0.94, P = 0.008) and residual aneurysm (RR 0.71, 95% CI 0.57 to 0.88, P = 0.002), but didn’t show any significant differences in other favorable outcomes such as functional recovery, mortality and so on. In the subgroup analysis, we found that second-generation hydrogel coils might exhibit potential impacts on increasing mid-term complete occlusion (RR 1.26, 95% CI 1.07 to 1.48, P = 0.005) and decreasing residual aneurysm neck. (RR 0.54, 95% CI 0.34 to 0.86, P = 0.010).ConclusionsHydrogel coils showed no significant efficacy on functional recovery but exhibited a lower rate of recurrences and residual aneurysms in patients with intracranial aneurysms.Electronic supplementary materialThe online version of this article (10.1186/s12883-018-1171-8) contains supplementary material, which is available to authorized users.

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“…All 4 RCTs [ 16 , 17 , 19 , 21 ] enrolling 1526 patients were pooled for the analysis of periprocedural and mid-term outcome respectively from two aspects of efficacy and safety.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hydrogel coils versus bare platinum coils for the endovascular treatment of intracranial aneurysms: a meta-analysis of randomized controlled trials

et al. 2018

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“…Giant aneurysms and those located at the posterior circulation are associated with higher complication rates after treatment with FDS [11]. The more durable results might mitigate the high complication rates after flow diversion for ruptured aneurysms and thus decreased rates of late rebleeding in comparison to conventional endovascular coiling where high recurrence rates of ruptured aneurysms is a significant drawback [5,12]. Longterm follow-up studies suggest high rates of progressive and durable occlusion after flow diversion for unruptured aneurysms, but the evidence is still limited [3,13,14].…”

Section: Safety and Efficacymentioning

confidence: 99%

“…Flow diversion greatly expanded the spectrum of treatable intracranial aneurysms by endovascular means [1]. With the appropriate indications and medical management, the use of flow diverter stents (FDS) can result in high rates of complete and permanent aneurysmal occlusion, a feature that has always been a major drawback of traditional endovascular treatment [2][3][4][5]. The low porosity and high mesh density of FDS facilitate aneurysmal occlusion by reducing the blood flow into the aneurysms and by serving as a scaffold for endothelialization across the aneurysm neck leading to progressive occlusion and reduced rates of recanalization of the treated aneurysm [6].…”

Section: Introductionmentioning

confidence: 99%

Flow Diversion for Treatment of Acutely Ruptured Intracranial Aneurysms

et al. 2019

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Background Reports about the use of flow diverter stents (FDS) in the acute setting of subarachnoid hemorrhage (SAH) are limited. This article presents a single center experiences based on 45 consecutive cases with emphasis on complication rates and clinical and radiologic outcomes. Methods A prospectively maintained database of all cases treated with FDS as a stand-alone or adjunct device was retrospectively reviewed. All patients treated within 30 days of SAH were included. Records were made of clinical presentation, details of endovascular treatment, procedural complications, clinical outcome, and degree of occlusion on follow-up. Results In this study 45 patients (48.9% females; mean age 58.8 ± 12.4 years) were included. Flow diversion was performed after a median of 4 days. The procedural complication rate was 13.3% resulting in 2.2% permanent morbidities and 4.4% mortalities. No major hemorrhagic complications related to antiplatelet therapy were recorded. Immediate complete occlusion was achieved in 13.3%. Among survivors, complete occlusion was achieved in 94.6%. Excellent clinical outcome was recorded in 68.9% and 81.6% of the total population and survivors, respectively. There were no records of rebleeding from the target lesions. Conclusion Flow diversion is an attractive alternative strategy for management of acutely ruptured aneurysms with high rates of delayed complete occlusion and acceptable complication rates.

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“…Past efforts to modify thrombogenicity of bare Pt coils involves enhancing the coil surface with bioactive components such as polyglycolic acid and hydrogel . Our approach is to use cold plasma processing, a dry (solvent‐free) process, to develop functional polymeric coatings which can easily be deposited on to three‐dimensional objects and whose surface chemistry can easily be varied and controlled, in order to regulate Fg adsorption as a first step toward studying the extent of thrombogenicity of the coils on aneurysm healing.…”

Section: Introductionmentioning

confidence: 99%

Plasma polymer films to regulate fibrinogen adsorption: Effect of pressure and competition with human serum albumin

Buddhadasa

Lerouge²,

Girard‐Lauriault

2018

Plasma Processes & Polymers

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are used to regulate fibrinogen (Fg) adsorption in the presence of human serum albumin (HSA), with the long-term intention of achieving control over platelet activation. This work includes a study of the effect of pressure on the films' surface chemistry, stability in phosphate buffer solution (PBS), and Fg adsorption. Tribometry tests against a polyethylene surface, in PBS, indicated that N-rich films were more susceptible to wear than the O-rich coating. Adsorption kinetics showed a distinct peak which suggested a multilayer formation of HSA owing to adsorption from a highly concentrated solution. Results conclude that Fg adsorption in the presence of a high concentration of HSA can still be regulated by the careful choice of film surface chemistry. K E Y W O R D Salbumin, fibrinogen, plasma polymerization, surface plasmon resonance, wear resistance

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Hydrogel versus Bare Platinum Coils in Patients with Large or Recurrent Aneurysms Prone to Recurrence after Endovascular Treatment: A Randomized Controlled Trial

Cited by 33 publications

References 35 publications

Hydrogel coils versus bare platinum coils for the endovascular treatment of intracranial aneurysms: a meta-analysis of randomized controlled trials

Hydrogel coils versus bare platinum coils for the endovascular treatment of intracranial aneurysms: a meta-analysis of randomized controlled trials

Flow Diversion for Treatment of Acutely Ruptured Intracranial Aneurysms

Plasma polymer films to regulate fibrinogen adsorption: Effect of pressure and competition with human serum albumin

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