Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Coil Type Does Not Affect Angiographic Follow-Up Outcomes of Cerebral Aneurysm Coiling: A Systematic Review and Meta-Analysis

Coil Type Does Not Affect Angiographic Follow-Up Outcomes of Cerebral Aneurysm Coiling: A... BACKGROUND AND PURPOSE: Previous studies varied in their conclusions about the superiority of second-generation coils compared with bare platinum. In this systematic review and meta-analysis, we assessed differences in reported unfavorable angiographic outcomes of cerebral aneurysms treated with coil embolization as a function of coil type. MATERIALS AND METHODS: This systematic review covered 1999–2011 through the use of Ovid MEDLINE and EMBASE. Search terms were “subarachnoid hemorrhage,” “intracranial aneurysms,” “endovascular treatment,” and “coiling.” Inclusion criteria were studies reporting >50 aneurysms with imaging follow-up. We defined “unfavorable angiographic outcome” as either “recanalization,” <90% occlusion, or “incomplete occlusion” at follow-up. Rates of unfavorable outcomes were pooled through the use of random effects models and compared across various coil types. Multivariate random effects meta-regression models were used to further explore the differences in outcomes related to coil type. RESULTS: We included 82 studies, comprising 90 patient cohorts, among which, 65 (72%) used bare platinum coils, 8 (8.9%) used Matrix, 11 (12%) used HydroCoil, and 6 (6.7%) used Cerecyte. The overall unfavorable outcome rate was 19% (95% CI: 17%,21%). Unfavorable outcome rates were 20% (95% CI: 17%, 22%) for bare platinum coils, 23% (95% CI: 16%, 29%) for Matrix, 15% (95% CI: 9%, 21%) for HydroCoil, and 15% (95% CI: 7%, 23%) for Cerecyte, respectively. The difference in unfavorable outcome rates among the various coil types was not statistically significant after adjusting for baseline characteristics, including aneurysm size, rupture status, and follow-up duration. CONCLUSIONS: The rate of unfavorable angiographic outcomes was not statistically different across the major approved coil types. The quality of the evidence, however, remains low because of high heterogeneity, small sample size, and potential publication bias. ABBREVIATIONS: MeSH Medical Subject Headings RCT randomized, controlled trial IQR interquartile range http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Coil Type Does Not Affect Angiographic Follow-Up Outcomes of Cerebral Aneurysm Coiling: A Systematic Review and Meta-Analysis

Loading next page...
 
/lp/american-journal-of-neuroradiology/coil-type-does-not-affect-angiographic-follow-up-outcomes-of-cerebral-0CKBS0VoNf

References

References for this paper are not available at this time. We will be adding them shortly, thank you for your patience.

Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2013 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A3598
pmid
23660290
Publisher site
See Article on Publisher Site

Abstract

BACKGROUND AND PURPOSE: Previous studies varied in their conclusions about the superiority of second-generation coils compared with bare platinum. In this systematic review and meta-analysis, we assessed differences in reported unfavorable angiographic outcomes of cerebral aneurysms treated with coil embolization as a function of coil type. MATERIALS AND METHODS: This systematic review covered 1999–2011 through the use of Ovid MEDLINE and EMBASE. Search terms were “subarachnoid hemorrhage,” “intracranial aneurysms,” “endovascular treatment,” and “coiling.” Inclusion criteria were studies reporting >50 aneurysms with imaging follow-up. We defined “unfavorable angiographic outcome” as either “recanalization,” <90% occlusion, or “incomplete occlusion” at follow-up. Rates of unfavorable outcomes were pooled through the use of random effects models and compared across various coil types. Multivariate random effects meta-regression models were used to further explore the differences in outcomes related to coil type. RESULTS: We included 82 studies, comprising 90 patient cohorts, among which, 65 (72%) used bare platinum coils, 8 (8.9%) used Matrix, 11 (12%) used HydroCoil, and 6 (6.7%) used Cerecyte. The overall unfavorable outcome rate was 19% (95% CI: 17%,21%). Unfavorable outcome rates were 20% (95% CI: 17%, 22%) for bare platinum coils, 23% (95% CI: 16%, 29%) for Matrix, 15% (95% CI: 9%, 21%) for HydroCoil, and 15% (95% CI: 7%, 23%) for Cerecyte, respectively. The difference in unfavorable outcome rates among the various coil types was not statistically significant after adjusting for baseline characteristics, including aneurysm size, rupture status, and follow-up duration. CONCLUSIONS: The rate of unfavorable angiographic outcomes was not statistically different across the major approved coil types. The quality of the evidence, however, remains low because of high heterogeneity, small sample size, and potential publication bias. ABBREVIATIONS: MeSH Medical Subject Headings RCT randomized, controlled trial IQR interquartile range

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Sep 1, 2013

There are no references for this article.