Treatment of basilar artery bifurcation aneurysms by using Guglielmi detachable coils: a 6-year experience

Abstract

Use of GDCs led to excellent clinical and angiographic results in the majority of patients with BA tip aneurysms included in this limited follow-up study. Rebleeding was encountered in one of the 34 previously ruptured BA aneurysms treated with GDCs, and no hemorrhages have been documented in the 11 unruptured aneurysms treated with GDCs in this series. Long-term follow-up studies are necessary before it is possible to compare adequately the treatment of aneurysms with coil placement to the gold standard of aneurysm clipping.

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.…”

21 Endovascular Treatment of Posterior Circulation Aneurysms

“…Although the general usefulness of this method has been recognized and it is increasingly being considered an alternative to surgical clipping in selected patients (Pierot et al 1996;Pierot et al 1997;Eskridge and Song 1998;Kuether et al 1998;Lempert et al 2000)., the utility, efficacy, and safety in distinct patient populations are still in the process of being defined Guglielmi et al 1992;Bavinzski et al 1999;Brilstra et al 1999;Byrne et al 1999;Lempert et al 2000).…”

“…Even after the development of innovative approaches to the skull base and technical improvements (Day et al 1997;Lawton et al 1997;Aziz et al 1999) the morbidity and mortality rates associated with their exposure remain high (Drake 1979;Hernesniemi et al 1992;Hillman et al 1996). Endovascular occlusion of intracranial aneurysms using Guglielmi electrolytically detachable coils (GDCs) has been accepted as a valuable therapeutic alternative to surgical clipping of basilar tip aneurysms in patients who were not candidates for surgical intervention because of their presentation in poor condition, advanced age or the difficult nature of their lesion (Guglielmi et al 1992;Peerless et al 1994;Bavinzski et al 1995;Nichols et al 1997;Kuether et al 1998;Bavinzski et al 1999;Byrne et al 1999). Basilar tip aneurysms in particular are well suited for endovascular approaches as for the distinct angiographic features of most of them.…”

“…Endovascular treatment of intracranial aneurysms by percutaneous endovascular coil embolization using Guglielmi electrolytically detachable coil (GDC) has been described as an alternative form of treatment with an increasing incidence in the literature (Guglielmi et al 1992;Bavinzski et al 1999;Byrne et al 1999;Lempert et al 2000).…”

“…Basilar tip aneurysms in particular are well suited for endovascular approaches as for the distinct angiographic features of most of them. The efficacy and optimal risk stratification for endovascular treatment is currently in the process of being defined (Guglielmi et al 1992;Bavinzski et al 1995;McDougall et al 1996;Nichols et al 1997;Kuether et al 1998;Bavinzski et al 1999;Brilstra et al 1999;Byrne et al 1999;Steiger et al 1999). …”