Electrothrombosis of saccular aneurysms via endovascular approach

Guglielmi, Guido; Viñuela, Fernando; Sepetka, Ivan; Macellari, Velio

doi:10.3171/jns.1991.75.1.0001

Cited by 935 publications

(213 citation statements)

References 19 publications

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“…A well known instance is the injection and subsequent coiling of long DNA in globules and viral capsids (e.g., [1][2][3]). A similar technique has been harnessed by neurosurgeons for the minimally invasive treatment of saccular aneurysms, into which detachable platinum wires are fed to initiate occlusion [4]. Extremely dense fiber packing can also be observed for example in gland thread cells of hagfish [5].…”

mentioning

confidence: 99%

Packing of elastic wires in flexible shells

Vetter¹,

Wittel²,

Herrmann³

2015

EPL

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The packing problem of long thin filaments that are injected into confined spaces is of fundamental interest for physicists and biologists alike. How linear threads pack and coil is well known only for the ideal case of rigid containers, though. Here, we force long elastic rods into flexible spatial confinement borne by an elastic shell to examine under which conditions recently acquired knowledge on wire packing in rigid spheres breaks down. We find that unlike in rigid cavities, friction plays a key role by giving rise to the emergence of two distinct packing patterns. At low friction, the wire densely coils into an ordered toroidal bundle with semi-ellipsoidal cross-section, while at high friction, it packs into a highly disordered, hierarchic structure. These two morphologies are shown to be separated by a continuous phase transition. Our findings demonstrate the dramatic impact of friction and confinement elasticity on filamentous packing and might drive future research on such systems in physics, biology and even medical technology toward including these mutually interacting effects.

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confidence: 99%

Packing of elastic wires in flexible shells

Vetter¹,

Wittel²,

Herrmann³

2015

EPL

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“…Endovascular embolization is a technique that occludes the aneurysms by placing some platinum coils into the neck of the ACoA. When this technique was first introduced in 1991 [17], it was used as an alternative treatment for patients who were not suitable for clipping due to size or location of the aneurysm [16, 17, 18, 19, 20]. With the introduction of controlled detachable coils to occlude the aneurysm, embolization has been increasingly used.…”

Section: Introductionmentioning

confidence: 99%

Neuropsychological Sequelae of Patients Treated with Microsurgical Clipping or Endovascular Embolization for Anterior Communicating Artery Aneurysm

Chan

Poon

2002

Eur Neurol

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Background and Purpose: While microsurgical clipping has been the choice of treatment for anterior communicating artery (ACoA) aneurysm, endovascular embolization is increasingly popular for treating intracranial aneurysms. Previous studies showed that in terms of mortality (i.e., death) and morbidity (i.e., functional outcome, independent living, rebleeding) rates, the clinical outcomes of coil embolization for intracranial aneurysms are as good as or even better than those of surgical clipping. However, little is known about the impact of these treatments on the cognitive functions of those survived after the treatment. Thus, the present study is designed to examine the cognitive deficits of patients treated with either surgical clipping or coil embolization. Method: Eighteen patients with a ruptured ACoA aneurysm were recruited. Half of them had undergone surgical clipping and the other half had endovascular embolization. Standardized neuropsychological tests were employed to assess their memory, executive function, motor ability, language and visual perceptual abilities. Results: The performance of the patients was in general poorer than that of the normal control subjects on tests of verbal memory, flexible thinking, ability to resist interference and motor control. However, in terms of severity, the patients who received surgical clipping demonstrated more severe impairment than those had endovascular embolization on these cognitive domains. In addition, while 33% of patients in the clipping group showed impairments on memory and executive function, no patient in the embolization group demonstrated these impairments. Conclusions: Patients with ACoA aneurysm demonstrated impaired verbal memory, executive function and motor abilities while their language and visual perception abilities remained relatively intact. However, when comparing the effect of treatment choice on the cognitive functions of these patients, the present results favored the coil embolization as the patients treated with coil embolization demonstrated significantly fewer severe cognitive deficits than patients who had undergone surgical clipping.

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“…Endovascular occlusion of saccular aneurysms with electrolytically detachable platinum microcoils was first reported by Guglielmi et al [9,10] in 1991. Since then, the endovascular treatment of cerebral aneurysms has been reported in several studies [8].…”

Section: Resultsmentioning

confidence: 99%

“…The synthesis and physical properties of GDCs the symptoms resolved. Seven RAAs located at the bifurcation and one at the have been described in detail elsewhere [9,10]. A platinum coil with a circular 'memory' is attached to a main renal artery were occluded totally by implantation of GDCs (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Endovascular treatment of renal artery aneurysms with conventional non‐detachable microcoils and Guglielmi detachable coils

Klein¹,

Szolar²,

Breinl³

et al. 1997

British Journal of Urology

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Objective To evaluate the efficacy and safety of endovascular occlusion of true renal artery aneurysms (RAAs) with conventional non‐detachable microcoils (NDCs) and Guglielmi detachable coils (GDCs). Patients and methods Over a 5‐year period, 12 RAAs were treated by endovascular selective embolization. Four RAAs were occluded using NDCs and eight were treated with GDCs. All coils were delivered through a microcatheter. Eight RAAs were located in the bifurcation of the main renal artery, two in the main renal artery and two were intrarenal. Before treatment, four patients presented with hypertension, one associated with renal infarction and a second had flank pain due to microembolization. Two other patients had renal infarction, associated with haematuria in one; one other patient also had haematuria and five patients were asymptomatic. All patients were followed using clinical and angiographic examinations after 6 months, 1 and 2 years. Results All RAAs were occluded successfully. In two patients treated with NDCs there were minor complications, i.e. one subsegmental peripheral infarction and one misembolization, both without clinical symptoms. In the group treated with GDCs there were no complications. Five of seven patients were clinically improved, while two patients remained clinically unchanged. Conclusion Superselective endovascular treatment of RAAs with microcoils is a safe, efficient, and less invasive alternative to surgical treatment. The high flexibility and softness of the GDC and the controlled detachment enables a safer and more complete occlusion of RAA than current alternatives.

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Electrothrombosis of saccular aneurysms via endovascular approach

Cited by 935 publications

References 19 publications

Packing of elastic wires in flexible shells

Packing of elastic wires in flexible shells

Neuropsychological Sequelae of Patients Treated with Microsurgical Clipping or Endovascular Embolization for Anterior Communicating Artery Aneurysm

Endovascular treatment of renal artery aneurysms with conventional non‐detachable microcoils and Guglielmi detachable coils

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