INITIAL EXPERIENCE WITH BIOACTIVE CERECYTE DETACHABLE COILS: IMPACT ON REDUCING RECURRENCE RATES
INITIAL EXPERIENCE WITH BIOACTIVE CERECYTE DETACHABLE COILS: IMPACT ON REDUCING RECURRENCE RATES
复制标题
生物活性 Cerecyte 可拆卸线圈的初步经验：对降低复发率的影响
作者：
E. Veznedaroglu;C. Koebbe;A. Siddiqui;R. Rosenwasser
尽管血管内弹簧圈栓塞颅内动脉瘤的安全性已得到证实，但再治疗的潜在需求仍受到批评。该前瞻性研究的目的是评估Cefaltte（Micrus Corp.，桑尼维尔，加利福尼亚州）生物活性线圈。方法176例患者的212例破裂和未破裂动脉瘤前瞻性纳入数据库登记研究，为期12个月。记录了直接归因于使用Cecilante弹簧圈的不良临床结局。在弹簧圈栓塞后立即和随访研究期间确定血管造影结果。排除了接受支架辅助或非Cephalte弹簧圈的所有患者。两名独立的血管内外科医生审查了后续照片。任何差异均视为复发。排除标准后，81例患者（89个动脉瘤）可接受至少6个月的随访。在这89例动脉瘤中，65%为破裂动脉瘤，并在急性情况下进行了治疗。动脉瘤的平均尺寸为7 mm。平均血管造影随访期为11.2个月。在6个动脉瘤（6.7%）中识别出因圆顶填充而需要再次治疗的复发。4个动脉瘤（4%）发生了超过20%的致密化，这被定义为基底的间质填充。有1起血栓栓塞事件导致永久性神经功能缺损。无化学性脑膜炎或迟发性脑积水病例发生。结论：Cephalte生物活性弹簧圈在破裂和未破裂动脉瘤中的应用似乎是安全有效的。弹簧圈内的生物活性聚合物具有与裸铂弹簧圈相似的操作特性。需要进行研究，通过直接比较铂弹簧圈和替代生物活性弹簧圈来评估长期结局。
OBJECTIVEDespite proven safety of endovascular coil embolization of intracranial aneurysms, the potential need for retreatment remains criticized. The goal of this prospective study was to assess the safety, durability, and effect on recanalization rates of the Cerecyte (Micrus Corp., Sunnyvale, CA) bioactive coil. METHODSTwo hundred twelve ruptured and unruptured aneurysms in 176 patients were prospectively enrolled in a database registry during a 12-month period. Adverse clinical outcomes directly attributed to the use of the Cerecyte coil were documented. Angiographic outcomes were determined immediately after coil embolization and during follow-up studies. All patients who received stent assistance or a non-Cerecyte coil were excluded. Two independent endovascular surgeons reviewed follow-up films. Any discrepancy was deemed a recurrence. RESULTSAfter exclusion criteria, 81 patients with 89 aneurysms were available for a minimum of 6 months of follow-up. Of those 89 aneurysms, 65% were ruptured aneurysms and were treated in the acute setting. The mean size of the aneurysm was 7 mm. The mean angiographic follow-up period was 11.2 months. Recurrences requiring retreatment as a result of dome filling were identified in six aneurysms (6.7%). Four aneurysms (4%) developed compaction of more than 20%, which was defined as interstitial filling of the fundus. There was one thromboembolic event leading to permanent neurological deficit. No cases of chemical meningitis or delayed hydrocephalus occurred. CONCLUSIONThe Cerecyte bioactive coil seems to be safe and effective for use in both ruptured and unruptured aneurysms. The bioactive polymer within the coils allows similar handling characteristics of a bare platinum coil. Studies to assess long-term outcomes with direct comparison to platinum coils and alternative bioactive coils are warranted.