Introduction: The Penumbra Coil 400TM System (PC400) are new platinum coils designed specifically to enhance filling efficiency by increasing coil diameter. Reported are the results of a comparison study to assess the PC400’s filling advantage in the treatment of cerebral aneurysms compared to conventional embolic coils (Controls). Particular focus was put on the extent to which the larger diameter affects acute packing density, embolization time and aneurysm occlusion at 6 months post-treatment.
Methods: This was a single center, retrospective case-review of 111 aneurysm cases treated in 110 patients by the PC400 (N=16) or Controls (N=95). Aneurysm and procedural characteristics were evaluated. Aneurysm volume and packing density were calculated using AngioCalc, an open source aneurysm calculator. Aneurysm occlusion was graded using investigator reported Raymond Scale classification immediately post-procedure, and at 6 (+ 2) months when patient follow-up was available. The data was then evaluated for statistical significance.
Results: There was no significant difference between patient characteristics between the groups. Although the Penumbra group had a statistically significant larger aneurysm volume (204.3 v. 154.5, p<0.05) this group had a significantly greater packing density (36.2% v. 27.5%, p<0.005). This was achieved with less coils, shorter procedure time and less coil length. Limited follow-up also shows a greater percentage of patients with complete aneurysm occlusion at 6 moths.
Conclusions: Aneurysm embolization with PC 400 achieved statistically significant greater packing density compared with conventional coils. This was achieved with less procedure time and less total number of coils despite statistically significant greater aneurysm volume. For patient follow-up, the 7 PC 400 cases had a greater percentage of Class I Raymond Scale occlusion compared to the controls with available data at 6 months. Our data confirms that when compared to conventional coils, the PC 400 is indeed more efficient in the embolization of cerebral aneurysm, without affecting accessibility or safety.
Patient Care: This research evaluates the importance of achieving higher packing density of coils in aneurysms treated with coil embolization in the long term treatment of aneurysms. This research also evaluates coil characteristics that may be useful in achieving this goal.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of packing density on the treatment of aneurysms with embolization, 2) Discuss coil characteristics important in packing density and 3) Identify the patients that would be amenable to treatment with this coil system.