Coil Type Does Not Affect Angiographic Follow-Up Outcomes of Cerebral Aneurysm Coiling: A Systematic Review and Meta-Analysis
Abstract
This meta-analysis of the literature sought to identify differences between outcomes of patients treated with first- and second-generation aneurysm coils. Unfavorable outcome was defined as recanalization, less than 90% occlusion, and/or incomplete occlusion at follow-up. In 82 published articles, unfavorable outcomes were reported in 20% of patients treated with bare platinum coils, 23% with Matrix coils, 15% with HydroCoil, and 15% with Cerecyte coils. These differences were not statistically significant. 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…
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