224 - Variability Between Hydrogel-based Coiling and Bare Platinum Coiling in the Treatment of Cerebral Aneurysms: A Systematic Review and Meta-Analysis

Purpose: Various coiling methods have been implemented to reduce or completely block flow to cerebral aneurysms. Recently, hydrogel-based coils are increasingly being discussed as alternatives to bare platinum coils in treatment of aneurysms. Limited research comparing both cohorts have made it challenging to understand treatment differences. Therefore, our objective was to systematically evaluate previous and recent literature comparing both groups.

Materials and Methods: The included patient cohort were selected from Randomized Control Trials (RCTs) occurring post 2010. The studies were selected following the PRISMA 2020 guidelines. Case reports, case series, case control studies, and studies comparing other forms of bioactive coiling to bare platinum coiling were excluded. Our primary endpoints were immediate occlusion and retreatment rates. Secondary endpoints include occlusion rate at follow-up, morbidity, mortality, and mRS scores (0-2) post treatment. R Studio Version 2025.09.0+387 was used for statistical analysis and plot generation.

Results: Six RCTs were included in the final version for analysis. The systematic review included a total of 2,551 patients with 1,278 patients in the Hydrogel-based coiling (HBC) group and 1,273 patients in the bare platinum coiling (BPC) group. Mean age was 55.84 and 56.89 in the HBC and BPC groups, respectively. Aneurysm dome sizes were similar between cohorts (8.51 mm in HBC vs. 8.71 mm in BPC), as were neck sizes (4.14 mm vs. 4.18 mm, respectively). Primary endpoint analysis showed comparable results between both groups. Occlusion rates revealed a trend towards HBC patients, though non-significant (OR 0.7682; 95% CI 0.5351; 1.1029; p=0.1197). Similarly, retreatment rates indicated no significant differences between both cohorts (0.7674; 95% CI 0.4759; 1.2373; p=0.2135). Results from secondary endpoint analysis are still pending.

Conclusion: Preliminary results show equivalent outcomes between the HBC and BPC when evaluating primary endpoints. Combined with our pending results from secondary endpoint analysis, this may offer further understanding of the differences and potential advantages or disadvantages of HBC compared to BPC.