Electrothrombosis of saccular aneurysms via endovascular approach

Abstract

Fifteen patients with high-risk intracranial saccular aneurysms were treated using electrolytically detachable coils introduced via an endovascular approach. The patients ranged in age from 21 to 69 years. The most frequent clinical presentation was subarachnoid hemorrhage (eight cases). Considerable thrombosis of the aneurysm (70% to 100%) was achieved in all 15 patients, and preservation of the parent artery was obtained in 14. Although temporary neurological deterioration due to the technique was recorded in one patient, no permanent neurological deficit was observed in this series and there were no deaths. It is believed that this new technology is a viable alternative in the management of patients with high-risk intracranial saccular aneurysms. It may also play an important role in the occlusion of aneurysms in the acute phase of subarachnoid hemorrhage.

The genetics of intracranial aneurysms

“…Historically, microsurgical clipping has been the preferred method of treatment. Endovascular treatment has been available as an alternative for the last 15 years (Guglielmi et al 1991). Multiple platinum coils of various length and diameter are packed into the aneurysm to exclude it from the circulation.…”

Severe Subarachnoid Hemorrhage With Pulmonary Edema Successfully Treated by Intra-aneurysmal Embolization Using Guglielmi Detachable Coils. Two Case Reports.

“…9,10) The feasibility of endovascular embolization with GDC as a primary modality for the treatment of surgically difficult cases has been assessed in cases of poor-grade aneurysmal SAH, 7) ruptured posterior circulation aneurysms, 1,13) multiple cerebral aneurysms, 18) and cerebral aneurysms with systemic complications. 12,14) Aneurysms associated with systemic complications were successfully treated by intra-aneurysmal GDC embolization in patients with chronic renal failure undergoing hemodialysis 14) and idiopathic thrombocytopenic purpura.…”

“…A Prowler 14 catheter (Cordis, Miami, Fla., U.S.A.) was inserted into the center of the aneurysmal lumen, and the aneurysm was embolized using 5 mm × 15 cm, 4 mm × 6 cm, and 3 mm × 3 cm GDCs (Target Therapeutics, Fremont, Calif., U.S.A.). 9,10) The coils were detached after confirming that the GDCs did not protrude into the parent artery. Postembolization angiography showed the disappearance of the aneurysm except for the neck remnant.…”

Combined Use of Electrolytically and Mechanically Detachable Platinum Coils for Endovascular Treatment of Cerebral Aneurysms

“…1,[4][5][6][7]9,11,13,14,16,19) The major advantage of this technique is the ability to retrieve the coils before final deployment to optimize the geometry of the coil. 4,6,11) However, there are some problems related to the GDC system, such as prolonged detaching time and high cost.…”