Embolization of Cerebral Aneurysms by Using the Guglielmi Detachable Coil

ABSTRACT

OBJECTIVE: The authors present the results of treatment and clinical outcome of intracranial aneurysm treated by Guglielmi detachable coil(GDC) embolization according to the location, size of the aneurysms and pre-operative state of patients. METHODS: We collected 222 patients who had 254 intracranial aneurysms and underwent endovascular treatment with GDC, which were treated at our institute during the 7-year period from 1995 to 2002. One hundred and forty-nine patients were females and 73 were males. Patient age ranged from 10 to 90 years(average 54.1 years). One hundred and thirty-eight aneurysms were presented with ruptured aneurysm, 116 with unruptured aneurysm. Sixty aneurysms were located in the posterior circulation and 194 in the anterior circulation. Among the 138 ruptured aneurysms, fifteen patients were classified as Hunt-Hess Grade I, 64 Grade II, 25 Grade III, 20 Grade IV, and 14 Grade V. RESULTS: Among total of 254 aneurysms, we were achieved 90 to 100% obliteration of the aneurysm in 228 cases(89.8%) but failed in 6(2.4%) and partial obliteration(below 90%) in 20(7.9%). Overall mortality rate was 1.6%(4 cases) including 2 poor preoperative neurological status(Hunt-Hess Grade IV-V), 1 Hunt-Hess Grade III case with post-embolic rebleeding and one failed-embolic rebleeding. CONCLUSION: Embolization of intracranial aneurysms with GDC is safe, effective and reliable, and short-term clinical results of the endovascular treatment of cerebral aneurysm indicate that this procedure is a useful alternative approach in selected patients. Further follow-up review is necessary to establish durability in the long term outcomes, indication of GDC embolization and protection of rebleeding.