| Objective: To analysis the 540 patients'angiography results with endovascular treatment of intracranial aneurysms, evaluate the curative effect of intracranial aneurysms embolized with Bare coils,Matrix,and HydroCoil.Methods: A retrospective analysis was conducted of a total of 540 patients harboring 595 aneurysms embolized with Bare coils, Matrix, and HydroCoil who had full clinic -al data in our hospital from 2003 to 2006 . Aneurysms that were treated with parent artery occlusion and stent-assisted coiling were excluded , as well as dissecting aneur -ysm, pseudoaneurysm and fusiform aneyrysm . The patients were divided into Bare coils group of 431 patients harboring 455 aneurysms , Matrix group of 79 patients harboring 86 aneurysms and HydroCoil group of 53 patients harboring 54 aneurysms. Statistics and contrast Coil- related operation complications , angiography outcomes immediately after treatment, aneurysms packing attenuation, clinical and angiography follow-up outcomes. Statist -ical analysis was performed using a commerciallly avail -able softwar -e package (SAS 13.0) . Datum for HydroCoil,Matrix and Bare coils were analyzed using X2 tests,Fisher exact tests,Kruskal-wallis H test and Nemenyi test. P<0.05 was considered significant.Results:1. Procedural complicationsProcedural complications rate of HydroCoil group,Matrix group and Bare coils group were 5.6%,8.1% and 6.2%, respectively. There were no statistically significant differences in procedural complications rate among these groups.Clinical complicati -ons that it cause: 54 aneurysms in 53 patients were coiled using HydroCoil coils, one of these patients experienced a permanent neurological deficit, and no one died; 86 an -eurysms in 79 patients were coiled using Matrix coils, two of these patients experien -ced a permanent neurological deficit , and one died ; 431 ane -urysms in 455 patients were coiled using Bare coils, nine of these patients experience -d a permanent neu rol -ogical deficit, and two died.2. Aneurysm packing attenuationPacking attenuation for HydroCoil (79%) was significantly greater (P < 0.01) than both Bare coils (24%) and Matrix (22%).3. Aneurysm complete obliteration rateComplete obliteration rate of HydroCoil group,Matrix group and Bare coils group were 81.5%,58.1%,72.3%, respectively.①Complete obliteration rate were better in aneurysms with≥50% HydroCoil coils (93.8%) than in aneurysms with < 50% HydroCoil (76.3%), although not statisti -cally significantly different . Complete obliteration rate for aneurysms with≥50% Matrix coils (51.5%) was more low (P=0.015) than aneurysms with < 50% Matrix (83.3%).②Complete obliteration rate of aneurysms with≥50% HydroCoil,aneurysms with≥50% Matrix coils and aneurysms with Bare coils were 81.5%,58.1%,72.3%, respectively . Initial angiographic results were worse for Matrix (P < 0.0125) than both Bare coils and HydroCoil.③Complete obliteration rate of small aneurysms with≥50% HydroCoil,small aneurysms with≥50% Matrix coils and small aneurysms with Bare coils were 92.9%,53.3%,73.9% , respectively . Initial angiographic results of small aneurysms were worse for Matrix (P < 0.0125) than both Bare coils and HydroCoil. Complete obliteration rate of large aneurysms with≥50% HydroCoil,large aneu -rysms with≥50% Matrix coils and large aneurysms with Bare coils were 70%,54.5 %,57.8% , respectively. There were no statistically significant differences in complet -e obliteration rate among these groups.4. Angiographic follow-upIn aneurysms with HydroCoil, 18 aneurysms in 19 patients had angiographic foll -ow-up, and in this group (average 8.2 months; range 4 to 36) , one aneurysm showed recurrence, the overall recanalization rate was 5.3%, no recurrent aneurysm need retre -atment, no case with recurrent hemorrhage; In aneurysms with Matrix, 37 aneurysms in 34 patients had angiographic follow-up , and in this group (average 9.2 months; ran -ge 1 to 32) , eight aneurysms showed recurrence , the overall recanalization rate was 21.6%, two(5.4%) recurrent aneurysm need retreatment, no case with recurrent hemo -rrhage; In aneurysms with Bare coils, 160 aneurysms in 151 patients had angiograph -ic follow-up, and in this group (average 10.9 months ; range 1 to 40) , 29 aneurysms showed recurrence , the overall recanalization rate was 18.1%, eleven(6.9%) recurrent aneurysms need retreatment, 2 cases with recurrent hemorrhage. There were no statis -tically significant differences in recanalization rate among these groups.①Recanalization rate of aneurysms having been obliterated completely of angio -graphic follow-up with HydroCoil,aneurysms having been obliterated completely of angiographic follow-up with Matrix and aneurysms having been obliterated complete -ly of angiographic follow-up with Bare coils were 0%,31.6%,9.2%, respectively. Recanalization rate of aneurysms having been not obliterated completely of ang -iographic follow-up with HydroCoil,aneurysms having been not obliterated comple -tely of angiographic follow-up with Matrix and aneurysms having been not obliterate -d completely of angiographic follow - up with Bare coils were 20%,11.1%,37.3%, respectively. Further thrombosis rate of these guoups were 60%,66.7 %,27.5%, resp -ectively. There were no statistically significant differences in recanalization rate amo -ng these groups. Further thrombosis rate for aneurysms having been not obliterated c -ompletely with Matrix was significantly greater (P =0.003) than Bare coils.②Recanalization rate of small aneurysms of angiographic follow-up with Hydr -oCoil,small aneurysms of angiographic follow-up with Matrix and small aneurysms of angiographic follow-up with Bare coils were 7.1%,25%,16.8%, respectively. The -re were no statistically significant differences in recanalization rate among these grou -ps.Recanalization rate of large aneurysms of angiographic follow-up with HydroCo -il,large aneurysms of angiographic follow-up with Matrix and large aneurysms of angiographic follow-up with Bare coils were 0%,0%,29.1%, respectively.③Recanalization rate of aneurysms of long-term angiographic follow-up with HydroCoil,aneurysms of long-term angiographic follow-up with Matrix and aneury -sms of long-term angiographic follow-up with Bare coils were 0%,28.6%,12.2%, respectively. There were no statistically significant differences in recanalization rate among these groups.5. There were 216 aneurysms of angiographic follow-up.①Recanalization rate of aneurysms with packing attenuation >25% and aneurys -ms with packing attenuation≤25% were 13.9%,20.9%, respectively. There were no statistically significant differences in recanalization rate between these groups.②There were 38 recurrent aneurysms and 178 aneurysms without recanalization. Packing attenuation of recurrent aneurysms was significantly lower (P=0.0332) than a -neurysms without recanalization.Conclusion: Endovascular treatment of intracranial aneurysms by using Matrix, Bare coils and HydroCoil is safe and feasible. Initial angiographic results were worse for Matrix than both Bare coils and HydroCoil. Packing attenuation for HydroCoil was significantly greater than both Bare coils and Matrix. Intracranial aneurysms by using HydroCoil have low recanalization rate for high packing attenuation . Durability of aneurysm occlusion with Matrix and HydroCoil in the long-term is still unknown and will be the focus of a future report from our series.A trial with a control group may be necessary to precisely assess the efficacy of two new devices.
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