HydroCoils Reduce Recurrence Rates in Recently Ruptured Medium-Sized Intracranial Aneurysms: A Subgroup Analysis of the HELPS Trial

Article Figures & Data

Table 1:

Baseline characteristics of medium-sized aneurysms

	HydroCoil	Control	P
Total patients (No.)	144	144	–
Sex
Female	100 (69.4)	102 (70.8)	.90
Male	44 (30.6)	42 (29.2)	.90
Age (yr)
45 or younger	42 (29.2)	49 (34.0)	.57
46–55	43 (29.9)	44 (30.6)
Older than 55	59 (41.0)	51 (35.4)
Dome-to-neck ratio
<1.5	43 (29.9)	50 (34.7)	.45
>1.5	101 (70.1)	94 (65.3)	.45
Rupture status
Recently ruptured	74 (51.4)	75 (52.1)	1.0
Unruptured/not recently ruptured	70 (48.6)	69 (47.9)	1.0
Use of assist device^{^a}
Yes	66 (46.2)	63 (44.4)	.81
No	77 (53.9)	79 (55.6)	.81
Balloon	39 (27.1)	33 (22.9)	.50
Stent	27 (18.8)	31 (21.5)	.66
Aneurysm shape
Irregular (multilobulated)	43 (29.9)	38 (26.4)	.60
Not multilobulated	101 (70.1)	106 (73.6)	.60
Aneurysm location
Anterior circulation	119 (82.6)	127 (88.2)	.13
Posterior circulation	25 (17.4)	17 (11.8)
Baseline WFNS
0	67 (46.5)	64 (44.4)	.76
I	66 (45.8)	64 (44.4)
II	9 (6.3)	14 (9.7)
III	2 (1.4)	2 (1.4)

Note:—WFNS indicates World Federation of Neurosurgical Societies.
↵a Data on assist device use were not available for 1 patient in the HydroCoil group and 2 patients in the control group.

Table 2:

Angiographic and clinical results of all patients with medium-sized aneurysms

	3–6 Months			15–18 Months
	HydroCoil (No.) (%)	Bare Platinum (No.) (%)	P	HydroCoil (No.) (%)	Bare Platinum (No.) (%)	P
No. of patients with angiographic follow-up	114	115	–	113	120	–
No. of patients with clinical follow-up	124	119	–	128	129	–
Any recurrence	23 (20.2)	35 (33.3)	.03^{^a}	40 (35.4)	55 (45.8)	.11
Major recurrence	11 (9.6)	17 (16.2)	0.16	21 (18.6)	37 (30.8)	.03^{^a}
Retreatment	1 (0.9)	2 (1.7)	1.0	3 (2.7)	5 (4.2)	.72
mRS ≤ 2	107 (86.3)	106 (89.1)	.56	113 (88.3)	116 (89.9)	.69

Table 3:

Angiographic and clinical results of patients with recently ruptured medium-sized aneurysms

	3–6 Months			15–18 Months
	HydroCoil (No.) (%)	Bare Platinum (No.) (%)	P	HydroCoil (No.) (%)	Bare Platinum (No.) (%)	P
No. of patients with angiographic follow-up	56	50	–	59	59	–
No. of patients clinical follow-up	63	64	–	65	65	–
Any recurrence	14 (25.0)	24 (48.0)	.02^{^a}	22 (37.3)	38 (64.4)	.006^{^a}
Major recurrence	4 (7.1)	13 (26.0)	.02^{^a}	12 (20.3)	28 (47.5)	.003^{^a}
Retreatment	0 (0.0)	0 (0.0)	1.0	0 (0.0)	2 (3.4)	.50
mRS ≤ 2	54 (85.7)	56 (87.5)	.80	56 (86.2)	59 (90.8)	.58

Table 4:

Angiographic and clinical results of patients with non-recently ruptured medium-sized aneurysms

	3–6 Months			15–18 Months
	HydroCoil (No.) (%)	Bare Platinum (No.) (%)	P	HydroCoil (No.) (%)	Bare Platinum (No.) (%)	P
No. of patients with angiographic follow-up	58	55	–	54	61	–
No. of patients with clinical follow-up	61	55	–	63	64	–
Any recurrence	9 (15.5)	11 (20.0)	.62	18 (33.3)	17 (27.9)	.55
Major recurrence	7 (12.1)	4 (7.3)	.53	9 (16.7)	9 (14.8)	.80
Retreatment	1 (1.7)	2 (3.6)	.61	3 (5.6)	3 (4.9)	1.0
mRS ≤ 2	53 (86.9)	50 (90.9)	.57	57 (90.5)	57 (89.1)	1.0

Table 5:

Multivariate logistic regression analysis^{^a}

	All Patients (OR) (95% CI)^{^b}	P	Recently Ruptured (OR) (95% CI)^{^c}	P	Non-Recently Ruptured (OR) (95% CI)^{^c}	P
Any recurrence	0.72 (0.43–1.20)	.21	0.37 (0.18–0.76)	.006	1.58 (0.73–3.47)	.25
Major recurrence	0.54 (0.30–0.98)	.04	0.27 (0.12–0.58)	.0007	1.55 (0.58–4.29)	.38
mRS ≤ 2	1.08 (0.51–2.32)	.83	0.96 (0.35–2.68)	.94	1.23 (0.38–4.06)	.73
Retreatment	0.51 (0.07–2.78)	.44	0.00 (0.00–2.01)	.12	0.97 (0.11–8.81)	.98

↵a Odds of HydroCoil versus the control group.
↵b Adjusted for neck size, use of adjunctive device, aneurysm shape, and rupture status.
↵c Adjusted for neck size, use of adjunctive device, and aneurysm shape.