Clinical and Radiologic Outcomes of the Optima Coil System for Cerebral Aneurysms

To evaluate the safety and feasibility of the Optima coil system for cerebral aneurysms.

Between 2020 and 2021, 474 patients with 534 cerebral aneurysms who underwent coil embolization using the Optima coil system were assessed and included in this study. The clinical and radiologic data were retrospectively analyzed using prospective registry data. The mean age was 61 years, and there were 510 unruptured and 24 ruptured aneurysms. The mean size of the aneurysms was 5.0±2.9 mm and the dome-to-neck ratio was 1.5±0.5.

After coiling, the mean packing density was 33±9%, and the ratio of the Optima coil volume to the total coil volume was 63±33%. Complication rates associated with coil embolization were as follows: procedural rupture in four (0.7%), spontaneous intracerebral hemorrhage in one (0.2%), and cerebral infarction in seven (1.5%) patients. Permanent neurological deficits were identified in two (0.4%) aneurysm cases. Follow-up MRA (available in 523 aneurysms) showed recanalization in 87 (17%) aneurysms. Retreatment was performed in twenty (3.8%) aneurysms. Female (p<0.001), previous coil embolization (p<0.001), subarachnoid hemorrhage (p=0.02), low packing density (p=0.03) and low Optima coil volume (p<0.001) were risk factors for recanalization according to a multivariable logistic regression analysis. A univariate linear regression analysis revealed that the use of the Optima coil was associated with a high packing density (p<0.001, packing density = 0.04 x Optima coil volume % + 30.09, R²=0.02).

The Optima coil system demonstrates acceptable safety and technical feasibility for the coil embolization of cerebral aneurysms in real-world clinical practice.