Evidence map›Paper›PMID 26228887›Full record

Trial reportAJNR. American journal of neuroradiology2015

HydroCoils Are Associated with Lower Angiographic Recurrence Rates Than Are Bare Platinum Coils in Treatment of "Difficult-to-Treat" Aneurysms: A Post Hoc Subgroup Analysis of the HELPS Trial.

W Brinjikji, P M White, H Nahser, J Wardlaw, R Sellar, A Gholkar, H J Cloft, D F Kallmes

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in AJNR. American journal of neuroradiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Comparison between second generation HydroSoft coils and bare platinum coils for the treatment of large intracranial aneurysms.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2023
    Article
  6. Article
  7. Review
  8. Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

W BrinjikjiFrom the Department of Radiology (W.B., H.J.C., D.F.K.), Mayo Clinic, Rochester, Minnesota brinjikji.waleed@mayo.edu.
P M WhiteInstitute for Ageing and Health (P.M.W., A.G.), Newcastle University, Newcastle-upon-Tyne, United Kingdom.
H NahserDepartment of Clinical Neuroscience (H.N.), University of Edinburgh, United Kingdom.
J WardlawWalton Centre (J.W., R.S.), Liverpool, United Kingdom.
R SellarWalton Centre (J.W., R.S.), Liverpool, United Kingdom.
A GholkarInstitute for Ageing and Health (P.M.W., A.G.), Newcastle University, Newcastle-upon-Tyne, United Kingdom.
H J CloftFrom the Department of Radiology (W.B., H.J.C., D.F.K.), Mayo Clinic, Rochester, Minnesota.
D F KallmesFrom the Department of Radiology (W.B., H.J.C., D.F.K.), Mayo Clinic, Rochester, Minnesota.
Mayo Clinic · USNewcastle Hospitals - Campus for Ageing and Vitality · GBUniversity of Edinburgh · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeThe HydroCoil Endovascular Aneurysm Occlusion and Packing Study was a randomized controlled trial that compared HydroCoils to bare platinum coils. Using data from this trial, we performed a subgroup analysis of angiographic and clinical outcomes of patients with "difficult-to-treat" aneurysms, defined as irregularly shaped and/or having a dome-to-neck ratio of <1.5. MATERIALS AND

methodsSeparate subgroup analyses comparing outcomes of treatment with HydroCoils to that of bare platinum coils were performed for the following: 1) irregularly shaped aneurysms, 2) regularly shaped aneurysms, 3) aneurysms with a dome-to-neck ratio of <1.5, and 4) aneurysms with a dome-to-neck ratio of ≥1.5. For each subgroup analysis, the following outcomes were studied at the last follow-up (3-18 months): 1) any recurrence, 2) major recurrence, 3) re-treatment, and 4) an mRS score of ≤2. Multivariate logistic regression analysis was performed to determine if the HydroCoil was independently associated with improved outcomes in these subgroups.

resultsAmong the patients with an irregularly shaped aneurysm, the HydroCoil was associated with lower major recurrence rates than the bare platinum coils (17 of 66 [26%] vs 30 of 69 [44%], respectively; P = .046). Among the patients with an aneurysm with a small dome-to-neck ratio, the HydroCoil was associated with lower major recurrence rates than the bare platinum coils (18 of 73 [24.7%] vs 32 of 76 [42.1%], respectively; P = .02). No difference in major recurrence was seen between HydroCoils and bare platinum coils for regularly shaped aneurysms (42 of 152 [27.6%] vs 52 of 162 [32.1%], respectively; P = .39) or aneurysms with a large dome-to-neck ratio (41 of 145 [28.3%] vs 50 of 155 [32.3%], respectively; P = .53).

conclusionsThis unplanned post hoc subgroup analysis found that HydroCoils are associated with improved angiographic outcomes in the treatment of irregularly shaped aneurysms and aneurysms with a dome-to-neck ratio of <1.5. Because this was a post hoc analysis, these results are not reliable and absolutely should not alter clinical practice but, rather, may inform the design of future randomized controlled trials.

Indexed as

AgedEmbolization, TherapeuticFemaleHumansIntracranial AneurysmMaleMiddle AgedPlatinumRadiographyRecurrenceTreatment OutcomePlatinum

Identifiers

PMID26228887
PMCPMC7968763
OpenAlexW2203618375

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.