HES Coils

GREAT: Randomized controlled multicentre study comparing HydroSoft™ / HydroFrame™ and bare platinum coils for endovascular aneurysm treatment

"Our results suggest that endovascular coil embolization with second-generation hydrogel coils may reduce the rate of unfavorable outcome events in patients with small- and medium-sized intracranial aneurysms."

Patients

484

Countries

France & Germany

Clinical Centers

22

Design

RCT (243 HES vs 241 BPC)

Scope

Patients 18-75 y.o. with an untreated aneurysm, ruptured or unruptured, with a dimater between 4 and 12mm, WFNS <4.

Purpose

To compare clinical and angiographic outcomes of second-generation Hydrocoils (HydroSoft™ and Hydroframe™) versus bare platinum coils.

Endpoints

Composite outcome: Major aneurysm recurrence on follow-up angiography + any aneurysm retreatment + morbidity that prevented patients from having angiographic controls (mRS between 3 and 5) + any death within 18 months after treatment.

Efficacy results

At 18 months:

  • Unfavorable composite primary outcome (recurrence, retreatment, morbidity, mortality): 19.9% (HES) vs 28.7% (BPC)

  • Complete occlusion: 69% (HES) vs 53% (BPC)

  • Major recurrence: 12% (HES) vs 18% (BPC)

  • Retreatment rate: 3% (HES) vs 6% (BPC)

Safety results

  • Procedural complications: 12.7% (HES) vs 12.4% (BPC)

  • 14-day mortality rate: 2.0% (HES) vs 2.1% (BPC)

At 18 months:

  • mRS 3-5: 3% (HES) vs 1% (BPC)

  • mRS 6: 3% (HES) vs 4% (BPC)

Rupt. An (within 30 days):

  • mRS 3-5: 5% (HES) vs 2% (BPC)

  • mRS 6: 5% (HES) vs 7% (BPC)

Unrupt. An:

  • mRS 3-5: 1% (HES) vs 1% (BPC)

  • mRS 6: 1% (HES) vs 2% (BPC)

SPONSOR: Freiburg Hospital Germany

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