Matrix Reloaded
===============

* H.J. Cloft

 *Have you ever had a dream, Neo, that you were so sure was real?* *Morpheus from* The Matrix, *Warner Bros, 1999* 

The saga of the Matrix coil in the neuroradiology world has some parallels to the cinematic saga of the same name. Both stories are about an entity called the Matrix. In each story, the Matrix created a very convincing illusion. In the end, the humans concerned with finding the truth succeed in breaking down the illusion. In this issue of *American Journal of Neuroradiology*, we are presented with yet another sequel in the series of publications regarding cerebral aneurysms treated with polyglycolic/polylactic acid (PGLA)-coated coils (Matrix; Boston Scientific, Natick, Mass)—that is, Matrix Reloaded. This latest publication is noteworthy because it is a very large multicenter series of patients. The results of this publication are disappointing in that they confirm previous findings,1–8 suggesting that PGLA-coated coils do not lead to a decrease in angiographic recurrence rates relative to platinum coils.

We are now awaiting the results of the Matrix and Platinum Science (MAPS) trial, which is a multicenter randomized prospective trial comparing aneurysms treated with Matrix coils with those treated with bare platinum coils. This should be the final chapter of the Matrix coil saga, in that the trial should finally put to rest the question of whether Matrix coils reduce cerebral aneurysm recurrences. As with the cinematic *Matrix* trilogy, we should hope that there is a dramatic finish that might be called the *Matrix Revolution*. However, previous publications in this serial saga have been disappointing and uninspiring, and we very well may expect the same from the final episode of the Matrix coil.

## References

1.  Niimi Y, Song J, Madrid M, et al. **Endosaccular treatment of intracranial aneurysms using Matrix coils: early experience and midterm follow-up.** Stroke 2006;37:1028–32. Epub 2006 Mar 2
    
    [Abstract/FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjk6IjM3LzQvMTAyOCI7czo0OiJhdG9tIjtzOjE4OiIvYWpuci8yOS8xLzYyLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

2.  Taschner CA, Leclerc X, Rachdi H, et al. **Matrix detachable coils for the endovascular treatment of intracranial aneurysms: analysis of early angiographic and clinical outcomes.** Stroke 2005;36:2176–80
    
    [Abstract/FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjEwOiIzNi8xMC8yMTc2IjtzOjQ6ImF0b20iO3M6MTg6Ii9ham5yLzI5LzEvNjIuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

3.  Wong GK, Yu SC, Poon WS. **Clinical and angiographic outcome of intracranial aneurysms treated with Matrix detachable coils in Chinese patients.** Surg Neurol 2007;67:122–26
    
    [CrossRef](http://www.ajnr.org/lookup/external-ref?access_num=10.1016/j.surneu.2006.05.063&link_type=DOI) 
    
    [PubMed](http://www.ajnr.org/lookup/external-ref?access_num=17254862&link_type=MED&atom=%2Fajnr%2F29%2F1%2F62.atom) 

4.  Murayama Y, Vinuela F, Ishii A, et al. **Initial clinical experience with Matrix detachable coils for the treatment of intracranial aneurysms.** J Neurosurg 2006;105:192–99
    
    [PubMed](http://www.ajnr.org/lookup/external-ref?access_num=17219822&link_type=MED&atom=%2Fajnr%2F29%2F1%2F62.atom) 

5.  Lubicz B, Leclerc X, Gauvrit JY, et al. **Endovascular treatment of intracranial aneurysms with Matrix coils: a preliminary study of immediate post-treatment results.** AJNR Am J Neuroradiol 2005;26:373–75
    
    [Abstract/FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo4OiIyNi8yLzM3MyI7czo0OiJhdG9tIjtzOjE4OiIvYWpuci8yOS8xLzYyLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

6.  Katsaridis V, Papagiannaki C, Violaris C. **Guglielmi detachable coils versus Matrix coils: a comparison of the immediate posttreatment results of the embolization of 364 cerebral aneurysms in 307 patients—a single-center, single-surgeon experience.** AJNR Am J Neuroradiol 2006;27:1841–48
    
    [Abstract/FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo5OiIyNy85LzE4NDEiO3M6NDoiYXRvbSI7czoxODoiL2FqbnIvMjkvMS82Mi5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

7.  Gonzalez NR, Patel AB, Murayama Y, et al. **Angiographic evidence of aneurysm neck healing following endovascular treatment with bioactive coils.** AJNR Am J Neuroradiol 2005;26:912–14
    
    [Abstract/FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo4OiIyNi80LzkxMiI7czo0OiJhdG9tIjtzOjE4OiIvYWpuci8yOS8xLzYyLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

8.  Fiorella D, Albuquerque FC, McDougall CG. **Durability of aneurysm embolization with Matrix detachable coils.** Neurosurgery 2006;58:51–59
    
    [CrossRef](http://www.ajnr.org/lookup/external-ref?access_num=10.1227/01.NEU.0000194190.45595.9E&link_type=DOI) 
    
    [PubMed](http://www.ajnr.org/lookup/external-ref?access_num=16385329&link_type=MED&atom=%2Fajnr%2F29%2F1%2F62.atom) 
    
    [Web of Science](http://www.ajnr.org/lookup/external-ref?access_num=000234453800011&link_type=ISI) 

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