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Journal of Long-Term Effects of Medical Implants
SJR: 0.332 SNIP: 0.491 CiteScore™: 0.89

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v14.i3.70
18 pages

Histologic and Hemodynamic Effects of Endosaccular Platinum Coils for Intracranial Aneurysms

Alex M. Barrocas
Department of Neurology, Georgetown University, Washington DC; and Ilnterventional Neuroradiology Service, Mallinckrodt Institute of Radiology, St. Louis, Missouri,USA
Colin P. Derdeyn
Associate Professor of Radiology and Neurology. Mallinckrodt Institute of Radiology 510 South Kings Highway Blvd. St. Louis MO 63110; and Departments of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
DeWitte T. Cross III
Interventional Neuroradiology Service, Mallinckrodt Institute of Radiology; and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
Christopher J. Moran
Interventional Neuroradiology Service, Mallinckrodt Institute of Radiology; and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
Ralph G. Dacey Jr.
Henry G. & Edith R. Schwartz Professor; Chairman of Neurological Surgery . Washington University School of Medicine 660 S. Euclid Avenue, Campus Box 8057 St. Louis MO 63110

ABSTRACT

Over the past 15 years, endosaccular platinum coil therapy for intracranial aneurysms has evolved from clinical pilot studies of investigational devices to common clinical practice. The mechanism by which these coils reduce the risk of aneurysm rupture—the primary goal of intracranial aneurysm treatment—is the focus of this review. Both histological mechanisms of scar formation and hemodynamic mechanisms of flow diversion may be involved. We will first review aneurysm epidemiology to provide the context and rationale for therapy for patients harboring intracranial aneurysms. Next, we will review the data for and theories of the pathophysiology of aneurysm formation, growth, and rupture, particularly as they relate to endovascular coil therapy. Histological and hemodynamic studies of coiled aneurysms in animals and humans will be reviewed. Fınally, we will discuss emerging coil-based therapies, such as bioactive polymer coatings for platinum coils and the adjunctive use of stents.