scholarly journals Late Thromboembolic Events after Treatment of Intracranial Aneurysms with Guglielmi Detachable Coils

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 356-357
Author(s):  
Colin P Derdeyn ◽  
Christopher J Moran ◽  
DeWitte T Cross ◽  
Michael R Chicoine ◽  
Ralph G Dacey
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Additional Patient ◽  
Superior Cerebellar Artery ◽  
Parent Artery ◽  
Imaging Data ◽  
Guglielmi Detachable Coils ◽  
Kaplan Meier ◽  
Detachable Coils

P98 Purpose: Thrombo-embolic complications associated with the endovascular treatment of intracranial aneurysms with Guglielmi Detachable Coils (GDC) generally occur at the time of the procedure or soon after. The purpose of this report is to determine the frequency of late thrombo-embolic events after GDC. Methods: The records of 189 patients who underwent GDC repair of one or more intracranial aneurysms at our institution were reviewed. The occurence of an ischemic event referrable to a coiled aneurysm was determined by clinical, angiographic, and imaging data. Events occuring within 2 days of the endovascular procedure were considered peri-procedural. Kaplan-Meier analysis of ischemic events over time was performed. Results: Two patients suffered documented thrombo-embolic events. One patient presented 5 weeks after coiling with a transient ischemic attack. Angiography demonstrated thrombus on the surface of the coils at the neck of a large ophthalmic artery aneurysm. The second patient presented with a posterior circulation stroke 4 weeks after coiling of a large superior cerebellar artery aneurysm. Angiography showed no significant proximal disease, with thrombus beginning at the neck of the treated aneurysm and extending out both P1 segments. No intra-procedural problems during the initial coiling had occured with either patient. There was no evidence for protrusion of coils into the parent artery in either patient. Both patients had been receiving daily aspirin (325 mg). One additional patient reporting symptoms suggesting possible ischemics event was evaluated and diagnosed as having atypical migraines. The frequency of a clinical thromboembolic event during the first year after coiling (excluding procedural complications) was 1.1%. Conclusions: Thrombo-embolic events may occur as late as 5 weeks after endovascular treatment of aneurysms with GDC.

scholarly journals Endovascular Treatment of Unruptured Intracranial Aneurysms With Guglielmi Detachable Coils

Stroke ◽  
2008 ◽  
Vol 39 (3) ◽  
pp. 899-904 ◽  
Author(s):  
Harald Standhardt ◽  
Hans Boecher-Schwarz ◽  
Andreas Gruber ◽  
Thomas Benesch ◽  
Engelbert Knosp ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Guglielmi Detachable Coils ◽  
Unruptured Intracranial Aneurysms ◽  
Detachable Coils

scholarly journals Endovascular Treatment of a Distal Aneurysm of the Superior Cerebellar Artery by Intra-Aneurysmal Injection of Glue

2001 ◽  
Vol 7 (4) ◽  
pp. 343-348 ◽  
Author(s):  
M. Leonardi ◽  
L. Simonetti ◽  
A. Andreoli
Keyword(s):  
Poor Prognosis ◽  
Superior Cerebellar Artery ◽  
Parent Artery ◽  
High Morbidity ◽  
Guglielmi Detachable Coils ◽  
Parent Vessel ◽  
Total Occlusion ◽  
Cerebellar Artery ◽  
Detachable Coils ◽  
Distal Location

Aneurysms in the distal cerebellar arteries are rare events. They are associated with a poor prognosis, as surgery or embolisation with Guglielmi detachable coils (GDCs) is very difficult. The ability to treat them surgically depends on the location of the aneurysm, but surgery is considered difficult and is associated with a high morbidity/mortality rate. Embolisation with GDCs may be difficult or impossible because of the distal location of the aneurysm or the unfavourable ratio between the size of the aneurysm and the size of the parent vessel. We report our experience in one case treated with intra-aneurysmal injection of glue. The aneurysm, located in the distal right superior cerebellar artery, was catheterized with a flow-guided microcatheter, and glue was slowly injected into the aneurysmal sac. The treatment resulted in total occlusion of the aneurysm with preservation of the parent artery.

scholarly journals Endovascular Treatment of Intracranial Aneurysms With Guglielmi Detachable Coils

Stroke ◽  
2002 ◽  
Vol 33 (1) ◽  
pp. 210-217 ◽  
Author(s):  
P. Ng ◽  
M.S. Khangure ◽  
C.C. Phatouros ◽  
M. Bynevelt ◽  
H. ApSimon ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Guglielmi Detachable Coils ◽  
Detachable Coils

Repositioning of Displaced Guglielmi Detachable Coils after Endosaccular Embolisation Using a Modification of the Neck Plastic Technique

1998 ◽  
Vol 4 (4) ◽  
pp. 317-322
Author(s):  
J.C. Chaloupka ◽  
D.C. Huddle
Keyword(s):  
Endovascular Treatment ◽  
Internal Carotid ◽  
Parent Artery ◽  
Guglielmi Detachable Coils ◽  
Coil Embolisation ◽  
Surgical Clipping ◽  
Detachable Coils

After undergoing prior partial surgical clipping of an acutely ruptured internal carotid aneurysm, a 29-year-old woman was referred for endovascular treatment of the gradually enlarging aneurysm remnant. The aneurysm had a somewhat peculiar ellipsoid configuration due to placement of the clip, with the largest dimension measuring less than 4 mm, and the neck measuring approximately 2 mm. Using the conventional endosaccular coil embolisation technique, two small electrolytically detachable coils were carefully folded into the aneurysm sac to produce excellent tight packing. However, immediately after detachment, a loop of the second coil inadvertently herniated out of the aneurysm into the center of the parent artery, exhibiting substantial pulse synchronous displacement. This created a potentially unstable situation for the remaining coils within the embolised aneurysm. To correct this problem we attempted to reposition the loop into the aneurysm using a modification of the previously described neck plastic technique. This technique succeeded without untoward complication. Although there are theoretical risks and limitations, the modified neck plastic technique may be useful in selective cases of inadvertent coil misplacement during endosaccular coil embolisation of aneurysms with the GDC system.

Balloon-assisted coil placement in wide-necked aneurysms

1997 ◽  
Vol 86 (4) ◽  
pp. 724-727 ◽  
Author(s):  
David I. Levy ◽  
Andrew Ku
Keyword(s):  
Gold Standard ◽  
Intracranial Aneurysms ◽  
Ophthalmic Artery ◽  
Standard Of Care ◽  
Parent Artery ◽  
Guglielmi Detachable Coils ◽  
Initial Attempt ◽  
Content Type ◽  
Detachable Coils ◽  
Fine Print

✓ Saccular intracranial aneurysms are a common and often fatal lesion. Whereas surgical treatment of these aneurysms continues to be the gold standard of care, certain situations arise for which surgery may not be the best option. In some of these cases, electrolytically detachable coils have been proven to provide outcomes superior to those seen for medical management alone. The authors present two cases of ophthalmic artery aneurysms that would not hold the Guglielmi detachable coils on the initial attempt. One aneurysm was 7 mm and one 4 mm, both with wide necks relative to the aneurysm sac. By using a balloon-assisted technique and blocking the parent artery with a nondetachable balloon, the coils could be safely placed in these aneurysms without herniation when the balloon was deflated. Both patients exhibited embolic symptoms after the procedure, one with a mild but permanent deficit. Although this technique requires manipulation of a second microcatheter and balloon, which increases its technical difficulties and is a higher risk procedure than standard coil placement, it has utility in patients who are not candidates for surgery.

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