Medical Student Positivo University Curitiba, Brazil
Introduction: The second generation HydroCoil Embolic System (HES) consists of a platinum core with integrated hydrogel and is designed to improve aneurysm filling to provide superior occlusion effectiveness, reduce retreatment rates and increase long-term durability. The aim of this study is to compare the effectiveness of HES versus bare platinum coils (BPC) for unruptured intracranial aneurysms.
Methods: A systematic review and meta-analysis were performed according to the PRISMA guidelines. MEDLINE, EMBASE, and Cochrane databases were searched from inception to October, 2022. No aneurysm recurrence and major aneurysm recurrence on angiographic follow-up, angiographic outcomes with occlusion complete were accessed as the endpoints of interest.
Results: We analyzed four RCTs and one prospective cohort that enrolled a total of 1,802 patients followed up for a weighted mean of 13.7 months. HES compared to BPC treatment was not associated with no major aneurysm recurrence no major recurrence (RR, 1.11; 95% CI, 1.02-1.21; I² = 0%), but no reduced risk of complete occlusion (RR, 1.23; 95% CI, 0.54-2.77; I² = 91%), major recurrence without retreatment (RR, 0.77; 95% CI, 0.57-1.05; I² = 53%). Publication bias was not suggested by funnel plot assessment.
Conclusion : HES compared to BPC may decrease major aneurysm recurrence, despite no apparent benefit in terms of recurrence without retreatment and complete occlusion.
