2113 Hydrogel-Coated Coil Use is Associated With Reduction of Vasoreactivity Indices and Increase in Ruptured Aneurysm Treatment Efficacy

INTRODUCTION: Hydrogel-coated coils (MicroVention, Inc.) (HCC) are platinum coils coupled with hydrogel that amplify their volume once deployed leading to increased packing density. Given modified mechanical properties of HCC, differences in vasoreactivity after HCC as compared to bare platinum coil (BPC) use are theoretically possible. There currently is limited evidence on coiling efficacy and vasoreactivity effects of HCC as compared to BPC. METHODS: Data from 53 consecutive patients undergoing ruptured intracranial aneurysm treatment using HCC (n=18) or BPC (n=35) were analyzed retrospectively. Patient demographics, Hunt and Hess and modified Fisher grades, TCD mean flow velocities, symptomatic vasospasm and aneurysm residual/recurrence rates and functional outcomes were compared. RESULTS: The distribution of age and sex were similar between the two groups (p=0.281 and 0.375, respectively). Similarly, no significant differences between the Hunt and Hess and modified Fisher grades were noted (p=0.583 and 0.934, respectively). HCC group had significantly lower TCD maximum flow velocities as compared to BPC group (52 vs 72.2 cm/s; p<0.001). The rate of symptomatic vasospasm was over two times higher in BPC vs the HCC group (25.7% vs 11.1% respectively; p=0.377). Rate of residual/recurrent aneurysms was significantly higher in BPC as compared to HCC group (57.1% vs 22.2% respectively; p=0.021) while the rate of retreatment was not significantly different (25% vs 15% respectively; p=0.544). Modified Rankin scale scores upon discharge and follow-up were not significantly different between the BPC and HCC groups (3.1 vs 2.9; p=0.647 and 1.6 vs 0.87; p=0.162, respectively). CONCLUSIONS: Ruptured intracranial aneurysm patients treated with HCC exhibit lower maximum TCD flow velocities, trend towards decreased symptomatic vasospasm rates and have significantly lesser rate of aneurysm residual/recurrence.