PC400 volumetric coils minimize radiation, reduce procedure time and optimize packing density during endovascular treatment in medium sized cerebral aneurysms

SummaryBackground and objectivesThe Penumbra Coil 400 (PC400) is designed to improve endovascular filling for intracranial aneurysms. The aim of this retrospective, single-operator study was to compare the use of the PC400 with conventional 0.010 inch coils in procedure time, X-ray exposure and packing density.MethodsWe collected data from 31 patients with 6 to 10 mm diameter aneurysms embolized using the PC400, from May 2012 to November 2013. This group was compared with a control group of 27 patients treated with conventional 0.010 inch coils by the same operator. In both groups, clinical events, number of coils used, duration and cost of procedure, time of fluoroscopy and packing density were studied.ResultsNo serious adverse events were found in either group. Asymptomatic prolapse of coil loop into the parent artery were noted in two patients. Number of coils used was 4.45/6.35 in PC400 and control groups, respectively. Duration of procedure was 29.8/49.2 minutes respectively (P-value = 0.0002), and time of fluoroscopy was 28/41 minutes (P-value = 0.0109). Total radiation was 6098/6876 cGy.cm2 respectively. Comparison of packing densities after the first coil showed respectively 22.7%/10.6%, and after the final imaging, 53%/28.5% (P-values < 0.0001). Complete or near complete occlusion on follow-up at 3 months was 100% for PC400 versus 92% in the control group. Using 0.010 inch coils may result in a 56% increase in treatment cost.ConclusionPC400 coils save procedural time and time of fluoroscopy, are cost saving and allow dramatic improvement of packing density on final imaging.