支架治疗颅内远端动脉瘤安全性和有效性分析

【摘要】 目的 探讨血管内支架治疗颅内远端动脉瘤的安全性和有效性。方法 回顾性分析2018年1月至2021年12月在河南省人民医院接受血管内支架治疗的40例颅内远端动脉瘤患者临床资料,动脉瘤共43枚。动脉瘤辅助支架栓塞治疗32例（34枚）,血流导向装置治疗8例（9枚）。颅内远端动脉瘤定义为位于前循环中A2/M2段、后循环中P2段及其远端动脉瘤。随访期采用Raymond分级评分评估动脉瘤栓塞情况,改良Rankin量表（mRS）评分评估临床预后。结果 34枚动脉瘤成功完成支架辅助弹簧圈栓塞治疗,末次影像随访结果显示31枚（91.2%）动脉瘤Raymond评分Ⅰ级,3枚Ⅱ级。4例（12.5%）患者发生手术相关缺血性并发症。中位随访6.5个月,31例（96.9%）患者mRS评分为0～2分,获得良好预后。9枚动脉瘤成功完成血流导向装置治疗,末次影像随访结果显示5枚动脉瘤Raymond分级Ⅰ级,3枚Ⅱ级,1枚失访。1例患者发生缺血性并发症。中位随访9个月,6例患者mRS评分为0～2分,获得良好预后。结论 血管内支架辅助栓塞颅内远端动脉瘤是一种安全有效的治疗策略。小口径支架应用提高了颅内远端动脉瘤治疗闭塞率,血流导向装置是用传统方法治疗具有挑战性的远端动脉瘤的有效替代方法。     

球囊联合支架辅助弹簧圈栓塞颅内分叉部宽颈动脉瘤

目的：分析球囊联合支架辅助弹簧圈栓塞术治疗颅内分叉部宽颈动脉瘤的优势。方法回顾性分析2014年1月至4月昆明医科大学第一附属医院采用球囊联合支架辅助弹簧圈栓塞术治疗20例共25枚颅内分叉部宽颈动脉瘤患者的临床资料。20例患者中曾患蛛网膜下腔出血12例,无出血史8例;25枚颅内分叉部宽颈动脉瘤中位于基部动脉未端分叉部14枚,大脑中动脉分叉部8枚,颈内动脉末端分叉部3枚。根据Raymond分级评价介入治疗术后即刻和3个月后三维DSA检查结果,根据改良Rankin 量表（mRS）评分评价术后3个月临床疗效。结果球囊联合支架辅助弹簧圈栓塞术后即刻三维DSA检查显示25枚颅内分叉部宽颈动脉瘤中RaymondⅠ级21枚,Ⅱ级2枚,Ⅲ级2枚;术后3个月DSA随访显示RaymondⅠ级20枚,Ⅱ级3枚,Ⅲ级2枚。术后3个月mRS评分显示17例患者0分,1例患者1分,均预后良好;2例患者4～6分,预后不良。结论球囊联合支架辅助弹簧圈栓塞术在颅内分叉部宽颈动脉瘤介入治疗术中具有明显优势。     

国产Tubridge血流导向装置治疗中小型颅内动脉瘤的短期疗效及安全性分析

目的 评估国产Tubridge治疗中小型颅内动脉瘤的短期疗效和安全性。方法 回顾性分析2020年8月至2021年12月在复旦大学附属华山医院静安分院介入科接受Tubridge治疗的23例颅内未破裂中小型（≤10mm）动脉瘤患者的临床资料,共计31个动脉瘤;术后采用改良Rankin量表（mRS）评分评估患者临床预后（0～2分为预后良好,3～5分为预后不良）,术后采用Raymond分级评估动脉瘤栓塞情况。结果 支架置入成功率100%。末次平均随访时间6.6个月,17例患者行数字减影血管造影（digital subtraction angiography,DSA）造影随访,其中RaymondⅠ级19个,RaymondⅡ级1个,RaymondⅢ级5个,末次造影随访动脉瘤完全栓塞率76%;术后发生1例出血并发症（4.4%）,2例缺血并发症（8.7%）,4例无症状性支架内膜增生伴轻度狭窄,症状性并发症发生率8.7%。全部患者获得临床随访结果,mRS≤2分22例,mRS>2分1例。结论 国产Tubridge治疗颅内中小型动脉瘤具有良好的效果,但是术后出血或缺血性并发症不容忽视。     

支架技术在颅内复杂动脉瘤治疗中的应用

目的探讨支架在颅内复杂动脉瘤中的治疗技术及应用价值。方法回顾性分析应用支架技术辅助栓塞治疗的31例颅内动脉瘤患者（宽颈动脉瘤28例,梭形动脉瘤3例）的临床资料。术中将支架引至动脉瘤处释放支架覆盖动脉瘤颈,并结合弹簧圈栓塞术。结果 31例共置入支架32枚,其中Enterprise支架24枚,LEO支架5枚,Solitaire AB支架3枚。采用单纯支架置入技术2例,此2例微小动脉瘤术后见瘤腔内造影剂滞留。支架结合弹簧圈治疗29例,其中支架先释放技术7例,支架后释放技术22例,支架结合弹簧圈治疗组取得满意疗效。术后即刻栓塞结果按改良的Raymond分级：动脉瘤体完全栓塞20例（Ⅰ级）,瘤颈残留7例（Ⅱ级）,瘤体显影2例（Ⅲ级）。随访1～6个月未发生再出血及缺血并发症。结论支架辅助栓塞技术是治疗颅内动脉瘤安全有效的方法,可提高动脉瘤栓塞的致密程度,采用支架后释放技术使绝大多数颅内复杂动脉瘤的介入治疗成为可能。     

LVIS支架辅助栓塞颅内破裂动脉瘤的有效性和安全性

目的：分析Lvis支架辅助栓塞颅内破裂动脉瘤的有效性及安全性。 方法：回顾性分析2014年4月至2018年2月在郑州大学第一附属医院神经介入科接受Lvis支架辅助栓塞颅内破裂动脉瘤的230例患者的临床资料,分析患者术后即刻的疗效及随访疗效,收集围手术期并发症发生情况,分析其出血事件发生率、缺血事件发生率、致死率和残疾率。 结果：230例患者术后即刻手术效果：Raymond Ⅰ级205例（89.1%）,Raymond Ⅱ级25例（10.9%）。术后12个月,180例患者获得随访,临床效果：Raymond Ⅰ级162例（90%）,Raymond Ⅱ级17例（9.6%）,Raymond Ⅲ级1例（0.4%）。230例患者发生并发症共计24例（14.0%）,1例（0.4%）术中动脉瘤破裂再出血,1例（0.4%）术后出现再出血,12例（5.2%）术中或术后支架内血栓,支架内血栓患者中3例（1.2%）出现缺血并发症,术后未发现支架内血栓或闭塞患者出现缺血并发症患者10例（4.3%）,所有并发症患者中出现8例致残（3.5%）,致死2例（0.8%）。 结论：Lvis支架辅助栓塞颅内破裂动脉瘤安全有效。     

眼动脉段动脉瘤血管内栓塞治疗方法探讨

目的 探讨颈内动脉眼动脉段动脉瘤血管内栓塞治疗方法及技术要点.方法 回顾性分析2012年5月至2015年4月郑州大学第一附属医院采用血管内栓塞术治疗48例眼动脉段动脉瘤患者影像及临床资料、治疗效果及随访结果,探讨治疗方法及技术要点.结果 48例患者49枚动脉瘤均栓塞成功,其中单纯弹簧圈栓塞17枚(双微导管3枚),球囊辅助栓塞2枚,支架辅助栓塞28枚(Leo支架3枚,Lvis支架5枚,Enterprise支架14枚,Solatire AB支架6枚),Willis覆膜支架隔绝1枚,Pipeline密网支架植入1枚.术后即刻DSA造影显示,Raymond栓塞分级I级34枚(69％),Ⅱ级9枚(18％),Ⅲ级6枚(13％).术中发生支架内血栓形成2例.48例均达到临床治愈,出院时改良Rankin量表(mRS)评分0分44例,1分2例,4分2例(该2例治疗前≥4分);出院后3个月至1年mRS评分0分46例,2分1例,4分1例,均无新发神经功能障碍及出血.20例DSA随访1～21个月,18例痊愈,1例明显好转,1例明显复发,再次手术致密栓塞.结论 血管内栓塞治疗眼动脉段动脉瘤是一种微创、安全有效的方法,选择不同栓塞技巧是保证手术成功、减少术后并发症、提高治愈率的关键.     

支架半释放技术辅助栓塞颅内复杂动脉瘤

目的初步评价支架半释放技术辅助栓塞颅内复杂动脉瘤的疗效及安全性。方法回顾性分析经支架半释放技术治疗的18例患者共19枚动脉瘤的临床资料,其中未破裂动脉瘤15枚,破裂动脉瘤4枚,按Hunt—Hess分级：Ⅱ级3例,Ⅲ级1例。结果本组病例共应用支架31枚,所有支架均成功释放,动脉瘤致密栓塞7例,瘤颈残留3例,瘤体显影9例;未发生手术相关并发症,术后无新发神经功能缺损,出院时改良Rankin评分（MRS）0分10例,1分4例,2分3例,3分1例。1～3个月的临床随访所有患者恢复良好,临床症状未见加重,亦未发生再出血或新发梗死。结论支架半释放技术辅助栓塞颅内复杂动脉瘤技术上是可行的,与其他支架释放技术相比,可操作性强,安全性高,瘤颈栓塞致密,即刻栓塞结果满意,但其长期疗效有待于进一步随访。     

大弹簧圈技术与传统方式栓塞治疗颈内动脉-后交通动脉瘤临床效果对比分析

【摘要】 目的 对比分析大弹簧圈技术与传统方式栓塞治疗颈内动脉-后交通动脉瘤的临床效果。方法 选取2018年6月至2020年6月云南省第二人民医院收治的68例颈内动脉-后交通动脉瘤介入栓塞治疗患者,根据手术方法不同分为实验组（大弹簧圈技术栓塞治疗）和对照组（传统方式栓塞治疗）,每组34例。比较两组术后即刻Raymond-Roy分级、动脉瘤填塞密度、弹簧圈用量、弹簧圈费用、术中支架辅助、手术并发症、出院时Glasgow预后量表（GOS）评分及术后6个月随访GOS评分。结果 实验组患者术后即刻Raymond-Roy分级、弹簧圈用量、弹簧圈费用均低于对照组,动脉瘤填塞密度高于对照组,差异均有统计学意义（P＜0.05）。两组患者术中支架辅助、手术并发症、出院时GOS评分及术后6个月随访GOS评分比较,差异无统计学意义（P＞0.05）。结论 大弹簧圈技术栓塞治疗颈内动脉-后交通动脉瘤安全有效,与传统方式相比,可提高动脉瘤栓塞密度和治愈率、降低动脉瘤复发率、减少弹簧圈用量及其费用。     

支架治疗颈内动脉分叉部宽颈动脉瘤

目的初步评价支架治疗颈内动脉分叉部宽颈动脉瘤的可行性、安全性和有效性。方法收集2004年1月至2010年12月11例颅内动脉瘤患者,共检出16枚颅内动脉瘤。其中位于颈内动脉分叉部的11枚动脉瘤均为宽颈动脉瘤,动脉瘤直径2.5～18 mm。所有患者采用不同类型支架及支架技术治疗,并于术后1、3、6、12个月进行随访。结果治疗中采用不同类型支架11枚,其中球扩支架1枚,自膨胀支架10枚。动脉瘤即刻栓塞结果按Raymond分级.Ⅰ级4枚,Ⅱ级2枚,Ⅲ级5枚。未发生手术相关并发症,出院时改良Rankin评分0～1分11例。11例患者随访1～108个月,均病情稳定,无新发的神经功能障碍。影像学随访7例,随访时间1～48个月,动脉瘤不显影4例,改善2例,稳定1例。结论对于颈内动脉分叉部宽颈动脉瘤,支架治疗技术可行,且安全有效,长期疗效有待于进一步研究。     

高分辨率C形臂CT在颅内动脉瘤Pipeline Flex植入术中的价值

【摘要】 目的 探讨颅内支架专用高分辨率XperCT在颅内动脉瘤Pipeline Flex植入术中的临床价值。方法 回顾性分析2019年10月至2020年5月昆明医科大学第一附属医院采用Pipeline Flex植入术治疗的12例患者颅内动脉瘤患者临床资料。对比分析二维DSA造影、常规颅脑XperCT及颅内支架专用XperCT在显示支架打开情况、支架与动脉瘤位置、支架与血管贴壁情况方面的差异。3名10年以上神经介入医师对图像质量进行量化评分。术后3个月患者随访复查,O’Kelly-Marotta（OKM）分级评价动脉瘤瘤腔闭塞情况,同时记录相关并发症。 结果 12例患者（15枚动脉瘤）共植入12枚Pipeline Flex。颅内支架专用高分辨率XperCT在显示支架打开情况方面显著优于二维DSA造影（P=0.007）,在显示支架与血管贴壁情况方面显著优于二维DSA造影（P=0.001）和常规颅脑XperCT（P=0.003）。12例患者获平均4.7个月（3～6个月）随访。术后3个月DSA造影复查显示患者OKM分级为A级0例,B级2例（16.7%）,C级4例（33.3%）,D级6例（50.0%）,均未出现相关并发症;术后4.7个月瘤腔完全栓塞率为50.0%（6/12）。 结论 颅内支架专用高分辨率XperCT在显示支架贴壁情况方面具有独特优势。术后常规行颅内支架专用高分辨率XperCT,可即刻显示支架打开及贴壁情况。     

Endovascular coiling of intracranial aneurysms using bioactive coils: a single-center study

BACKGROUND: Some degree of recanalization is reported in up to one-third of intracranial aneurysms treated with endovascular coiling. A technical development potentially effective in avoiding recanalization is the Matrix Detachable Coil (MDC), which is covered with a biodegradable polymeric material that enhances intra-aneurysmal clot organization and fibrosis. Purpose: To report the initial clinical experience of MDC for endovascular aneurysm coiling in a single-center, single-operator, and well-defined population setting. MATERIAL AND METHODS: 118 aneurysms in 104 patients (73 with subarachnoid hemorrhage, SAH) were embolized with MDC alone (n = 52) or combined with bare platinum coils (n = 66). RESULTS: Initial aneurysm obliteration was class 1 (complete obliteration) in 45 aneurysms (38.1%), class 2 (residual neck) in 44 (37.3%), and class 3 (residual aneurysm) in 29 (24.6%). Procedure-related morbidity was 4.8%, and mortality 0.96%. Clinical follow-up of 61 patients with SAH (mean 5.9 months, range 1-17 months) showed good outcome (Glasgow Outcome Scale, GOS 4-5) in 39 (63.9%), and poor outcome or death (GOS 1-3) in 22 (36.1%). Imaging follow-up of 73 aneurysms (average 6.5 months, range 1-17 months) showed class 1 in 47 (64.4%), class 2 in 18 (24.7%), and class 3 in eight (10.9%). Recanalization occurred in 11 aneurysms (15%), of which four (5.5%) required re-treatment. CONCLUSION: This study confirms that aneurysm coiling with MDC is feasible, effective, and safe.     

Abciximab in patients with ruptured intracranial aneurysms

BACKGROUND AND PURPOSE: Experience with intravenous abciximab to manage thromboembolism during treatment of ruptured intracranial aneurysms is limited. We present our experience in 13 patients. METHODS: We retrospectively reviewed all patients with thromboembolic complications during endovascular management of ruptured intracranial aneurysms. Thromboembolic complications were treated with intravenous abciximab. We recorded patient and aneurysm demographics, aneurysm occlusion, drug therapy, complications, and outcomes. RESULTS: World Federation of Neurological Surgeons Grades were 1 or 2 in 11 patients (85%). Median time from diagnostic angiography to treatment was 1 day. Ten (77%) aneurysms involved the anterior or posterior communicating artery, and one each occurred in the posterior inferior cerebellar artery, middle cerebral artery, and basilar regions. Eleven aneurysms were <10 mm. Five were incompletely occluded (0%-90% treated) at the time of the complication. Thromboembolic complications were at the coil-ball/parent-artery interface in nine patients (69%). Two were associated with coil-loop prolapse; one was prophylactically treated without evidence of thromboembolism. Five patients (38%) had distal complications; one also had a proximal thrombus. All patients received an intravenous bolus of abciximab (5-10 mg in 92%) without infusion. Postprocedural recanalization was complete in eight (62%) and partial in four (31%). Eleven patients (85%) had a Glasgow Outcome Scale score of 1 at 3 months. One had a poor outcome (GOS4). One died following additional coiling after abciximab administration, though this intervention was uneventful in three others. CONCLUSION: Abciximab completely or partially treated thromboembolic complications arising during coiling of ruptured aneurysms. Further coiling should be performed with extreme caution and needs to be decided on a patient-by-patient basis.     

不同治疗策略对颅内蛇形动脉瘤的短中期结局影响

目的探讨不同手术方式和治疗策略对颅内蛇形动脉瘤患者的短中期结局影响。 方法回顾性分析2015年1月至2018年6月南方医科大学南方医院收治的6例颅内蛇形动脉瘤患者的临床资料，按照要求纳入不同治疗组，经过定期随访头颅CT、MRI和DSA等，观察蛇形动脉瘤的形态转归以及神经功能缺损改善，术后GOS和mRS评分变化，以判断患者的预后是否良好。 结果该6例颅内蛇形动脉瘤均实现完全或近完全闭塞，GOS评分为4～5分，mRS评分为0～1分，患者无新发神经功能缺损。 结论考虑解剖位置和相关因素的不同治疗策略，可以改善蛇形动脉瘤的临床转归及预后。     

Procedural morbidity and mortality of elective coil treatment of unruptured intracranial aneurysms

BACKGROUND AND PURPOSE: To report morbidity, mortality, and angiographic results of elective coiling of unruptured intracranial aneurysms. METHODS: In a 10-year period, 176 unruptured aneurysms in 149 patients were electively treated with detachable coils. Seventy-nine aneurysms were additional to another ruptured aneurysm but were coiled more than 3 months after subarachnoid hemorrhage, 59 aneurysms were incidentally discovered, and 38 aneurysms presented with symptoms of mass effect. Mean size of the 176 unruptured aneurysms was 10.6 mm (median, 8 mm; range, 2-55 mm). One hundred thirteen aneurysms (64%) were small (<10 mm), 44 aneurysms (25%) were large (10-25 mm), and 19 aneurysms (11%) were giant (25-55 mm). Thirty wide-necked aneurysms (17%) were coiled with the aid of a supporting device. RESULTS: Procedural mortality of coiling was 1.3% (2 of 149; 95% confidence interval [CI], 0.7-5.1%), and morbidity was 2.6% (4 of 149, 95% CI, 0.8-7.0%). The 4 patients with permanent morbidity were independent (GOS 4). Initial aneurysm occlusion was complete (100%) in 132 aneurysms, nearly complete (90%-98%) in 36 aneurysms, and incomplete (60%-85%) in 8 aneurysms. Six-month follow-up angiography was available in 132 patients with 154 coiled aneurysms (87.5%); partial reopening occurred in 25, mainly large and giant aneurysms (16.2%). Additional coiling was performed in 22 aneurysms and additional parent vessel occlusion in 1 aneurysm. There were no complications of additional treatments. CONCLUSION: Elective coiling of unruptured intracranial aneurysms has low procedural mortality and morbidity. For the management of unruptured aneurysms, endovascular treatment should be considered.     

Coiling of very large or giant cerebral aneurysms: long-term clinical and serial angiographic results

BACKGROUND AND PURPOSE: Initial complete occlusion of very large or giant aneurysms often cannot be accomplished, and most will partially reopen over time. This study was performed to assess the clinical and angiographic outcome of patients with very large or giant cerebral aneurysms treated with detachable coils. METHODS: During 6 years, 29 patients with 31 very large or giant (20-55-mm) cerebral aneurysms were initially treated with detachable coils. Nineteen patients presented with subarachnoid hemorrhage (SAH), and eight patients had symptoms of mass effect. One patient had an incidental aneurysm, and one patient had an additional aneurysm. RESULTS: Twenty-three (79%) of 29 patients had a good clinical outcome at a median follow-up of 50 months. One of 19 patients presenting with SAH had repeat bleed (annual rebleeding rate, 1.45%). After initial coiling, seven of 31 aneurysms were incompletely occluded; this rate increased to 20 of 29 aneurysms at 6-month follow-up angiography. After 16 repeat coiling procedures in 13 aneurysms, 12 of 29 aneurysms in surviving patients were still incompletely occluded. After additional treatment other than coiling (parent-vessel occlusion and/or surgery) in eight aneurysms, three of 25 aneurysms in 24 surviving patients were incompletely occluded. Only 13 (42%) of 31 aneurysms had one coiling as a sole therapy. CONCLUSION: Coiling of very large or giant aneurysms can be considered. Long-term clinical outcomes were good in 79% of patients. The stability of the coil mesh over time was poor, requiring repeat coiling, surgery, and/or parent-vessel balloon occlusion in 58% of the aneurysms primarily treated with coils.     

经翼点入路显微手术夹闭治疗大脑前循环动脉瘤

目的:探讨经翼点入路显微手术夹闭治疗颅内动脉瘤的方法。方法:应用显微神经外科技术,对12例颅内动脉瘤患者进行直视手术。经翼点入路,以Mayfield头架固定头部,取自耳屏前方、颧弓上缘至中线发际内做弧形切口。根据需要充分显露载瘤动脉后,再解剖瘤颈。结果:12例颅内动脉瘤手术夹闭成功,以格拉斯哥预后评分量表对患者神经功能评分,评分好的10例,差的1例,死亡1例。结论:经翼点入路,应用显微外科技术,手术路径最短,视野角度最大,是治疗大脑前循环动脉瘤的经典入路。     

颅内动脉瘤显微手术与血管内介入治疗疗效比较

目的 比较颅内动脉瘤显微外科手术与血管内介入治疗的疗效.方法 回顾性分析颅内动脉瘤行血管内介入和显微手术治疗各54例患者资料,比较两组术后恢复良好率、GOS评分、并发症发生率、平均住院时间.结果 根据GOS评分,介入治疗组术后恢复良好、轻残、重残、植物生存、死亡分别为41例、6例、4例、2例、1例,而显微手术组分别为39例、8例、5例、1例、1例.介入治疗组、显微手术组的并发症分别为5例（9.26％）、6例（占11.1％）,平均住院时间分别为（8.2±0.9）d、（8.3±1.0）d.两组术后恢复良好率、GOS评分、并发症发生率、平均住院时间比较,差异均无统计学意义.结论 血管内介入与显微手术治疗颅内动脉瘤疗效无明显差异,应根据不同病情选择更有效的治疗方法.     

Mechanical Recanalization Using Solitaire AB Device for Severe Thromboembolic Events in Endovascular Treatment of Intracranial Aneurysms

Introduction

Severe thromboembolism with complete occlusion of the proximal arteries during or after coil embolization can cause serious neurologic deficits. The study aimed to assess the effectiveness and safety of Solitaire AB device as a rescue therapy for severe thromboembolic complications in the endovascular treatment of intracranial aneurysms.

Materials and Methods

Between February 2013 and April 2016, 1047 intracranial aneurysms treated with endovascular procedures were retrospectively reviewed in our center. Severe thromboembolisms occurred in ten patients and were treated by Solitaire AB device including clot retriever and permanent stent deployment.

Results

The location of arterial occlusion was distal to the aneurysm rather than the coil/parent artery interface or in-stent area. Four patients had distal thromboembolic events before coil embolization, and six patients had it after coiling. The complete arterial recanalization (TICI 3) was achieved in all patients, and no cerebral hemorrhage was related to the procedure after the rescue therapy. Among these patients with the aforementioned neurovascular procedures, the mean Glasgow Outcome Scale (GOS) score was 4.5 (ranging 3–5) and eight cases had good outcome with a score of GOS 4–5 at discharge, while eight patients presented mRS ≤2 at 3-month follow-up.

Conclusions

These results demonstrate that mechanical recanalization using Solitaire AB device seems to be effective and safe as a rescue therapy for severe thromboembolic events during cerebral aneurysm embolization.

     

Endovascular treatment of intracranial aneurysms with matrix detachable coils: immediate posttreatment results from a prospective multicenter registry

BACKGROUND AND PURPOSE: Endovascular treatment of intracranial aneurysms by using detachable coils has become an accepted alternative to surgery. To reduce the rate of aneurysm recanalization after treatment, biologically active polyglycolic/polylactic acid-covered platinum coils have been proposed. A prospective and multicenter registry was conducted in France to evaluate the safety and short-term and long-term efficacy of Matrix detachable coils. This first analysis is focused on the safety and short-term efficacy. METHODS: Two hundred sixty-one patients having ruptured or unruptured aneurysms treated via endovascular approach were included in this registry. Patients with giant aneurysms or in poor clinical condition (Glasgow Coma Scale < 10) were excluded. Because of various protocol violations, clinical analysis was conducted in 236 patients having 244 aneurysms. Technical and clinical complications were systematically recorded. Angiographic analysis was performed by a core laboratory by using the Raymond Grading Scale on 224 patients having 232 aneurysms. RESULTS: Complete occlusion was achieved in 102 aneurysms (44.0%); neck remnant, in 58 aneurysms (25.0%); and aneurysm remnant, in 72 aneurysms (31.0%). Technical and clinical complications related to the procedure were encountered in 43 patients (18.2%). Postoperative modification of the clinical status was observed in 12 patients (5.1%). Two patients died (0.8%), 6 had a permanent deficit (2.5%), and 4 had a transient deficit (1.7%). Treatment-related mortality was 0.8% and permanent morbidity was 2.5%. CONCLUSION: Endovascular treatment of intracranial aneurysms by using Matrix detachable coils is feasible and demonstrated initial angiographic results and overall morbidity and mortality rates that are within the ranges found in the literature in the use of bare platinum coils.