scholarly journals Iatrogenic Rupture of a Cerebral Aneurysm on the Feeding Artery of an Arteriovenous Malformation

2000 ◽  
Vol 6 (2) ◽  
pp. 141-145
Author(s):  
R. Guzman ◽  
L. Remonda ◽  
K.O. Lövblad ◽  
A. Barth ◽  
G. Schroth
Keyword(s):  
Arteriovenous Malformation ◽  
Endovascular Treatment ◽  
Cerebral Aneurysm ◽  
Acute Onset ◽  
Ruptured Aneurysm ◽  
Feeding Artery ◽  
Detachable Coil ◽  
Guglielmi Detachable Coil

We present the case of a patient with acute onset of headache who showed a flow-related acutely ruptured aneurysm on the feeding artery of an AVM in the angiogram. Rerupture of the aneurysm occurred during angiography after endovascular treatment with a Guglielmi detachable coil. The possible mechanisms leading to rupture of the aneurysm are discussed.

scholarly journals Intraaneurysmal Embolization for Wide-Necked Aneurysms Remodeling Technique, Combined Neck-Clipping and Coiling Therapy, Scaffolding Technique

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 95-101 ◽  
Author(s):  
T. Nakahara ◽  
T. Hidaka ◽  
M. Kutsuna ◽  
M. Yamanaka ◽  
K. Sakoda
Keyword(s):  
Endovascular Treatment ◽  
Neurological Deficits ◽  
Circulation System ◽  
Parent Artery ◽  
Anterior Circulation ◽  
Detachable Coil ◽  
Obliteration Rate ◽  
Guglielmi Detachable Coil ◽  
Scaffolding Technique

We reported the results of the endovascular treatment using Guglielmi detachable coil (GDC) for wide-necked aneurysms. Fourteen aneurysms were treated with remodeling technique. One aneurysm was performed endovascular treatment followed by partial neck clipping. The other was treated with scaffolding technique. All aneurysms could not be performed by conventional GDC treatment initially because of coil protrusion into the parent artery due to wide neck of these aneurysms. These aneurysms sited at anterior circulation system in 10 cases, and at posterior circulation system in 6 cases. Immediately after the procedure, the obliteration rate could be obtained complete occlusion in 3 cases, > 95% occlusion in 7 cases, > 90% occlusion in 3 cases and < 90% occlusion in 3 cases. In 14 patients follow-up angiography or magnetic resonance image (MRI) was carried out. The angiographic follow-up period is range from 2 to 19 months (mean: 10 months). The results of angiographical follow-up indicated increasing obliteration rate with all aneurysms except for 2 cases. In these 2 cases, the reembolization was needed for recanalization of the aneurysm. The clinical follow-up period is range form one to 26 months (mean: 15 months). There is no evidence of aneurysmal rupture and all cases have been survival without any permanent neurological deficits. The GDC treatment with additional technique (remodeling technique, combined neck-clipping and coiling therapy, scaffolding technique) provides safety and effectiveness, even if there are wide-necked aneurysms.

Causes and management of aneurysmal hemorrhage occurring during embolization with Guglielmi detachable coils

1998 ◽  
Vol 89 (1) ◽  
pp. 87-92 ◽  
Author(s):  
Cameron G. McDougall ◽  
Van V. Halbach ◽  
Christopher F. Dowd ◽  
Randall T. Higashida ◽  
Donald W. Larsen ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Contrast Material ◽  
Significant Risk ◽  
Detachable Coil ◽  
Content Type ◽  
Guglielmi Detachable Coil ◽  
Detachable Coils ◽  
Permanent Morbidity ◽  
Fine Print

Object. The purpose of this review is to describe the incidence, causes, management, and outcome of aneurysmal hemorrhage that occurred in patients during endovascular treatment with the Guglielmi detachable coil (GDC) system. Methods. At the authors' institution between September 1991 and August 1995, more than 200 patients were treated using GDCs for intracranial aneurysms. The first 200 patients treated in this fashion were reviewed and all who experienced new subarachnoid hemorrhage (SAH) during the procedure were identified. Angiographic studies were also reviewed and patients were contacted for longer-term follow up when possible. Four patients who experienced intraprocedural SAH were identified. The causes of hemorrhage were believed to be perforation of the aneurysm by the guidewire in one patient, perforation by the microcatheter in a second, and perforation by the delivery wire in a third. The fourth patient had a hemorrhage during injection of contrast material for control angiographic studies after placement of the final coil. One patient died, but the other three experienced no neurological symptoms or recovered without acquiring additional deficits. Overall a procedural hemorrhage rate of 2% was seen, with permanent morbidity and mortality rates of 0% and 0.5%, respectively. Conclusions. Although SAH during endovascular treatment of intracranial aneurysms remains a significant risk, its incidence is low and a majority of patients can survive without serious sequelae.

Safety of endovascular treatment of intracranial aneurysms with a new, complex shaped Guglielmi detachable coil

2007 ◽  
Vol 49 (9) ◽  
pp. 761-766 ◽  
Author(s):  
Christian A. Taschner ◽  
Xavier Leclerc ◽  
Jean-Yves Gauvrit ◽  
Anis Kerkeni ◽  
Mohamed El-Mahdy ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Detachable Coil ◽  
Guglielmi Detachable Coil

scholarly journals Embolization of a peripheral cerebral aneurysm associated with intracranial major artery occlusion through a transdural anastomotic artery: Case report

2018 ◽  
Vol 25 (2) ◽  
pp. 172-176 ◽  
Author(s):  
Norito Fukuda ◽  
Kazuya Kanemaru ◽  
Koji Hashimoto ◽  
Hideyuki Yoshioka ◽  
Nobuo Senbokuya ◽  
...  
Keyword(s):  
Cerebral Aneurysm ◽  
Artery Occlusion ◽  
Endovascular Embolization ◽  
Acute Onset ◽  
Ruptured Aneurysm ◽  
Occipital Artery ◽  
Collateral Vessel ◽  
Pericallosal Artery ◽  
Collateral Vessels ◽  
The Right

A peripheral cerebral aneurysm is known to develop at collateral vessels as a result of hemodynamic stress by the occlusion of the intracranial major arteries. We report a case of successful embolization of a ruptured aneurysm through a transdural anastomotic artery. The aneurysm formed at the developed collateral vessel from the meningeal branch of the occipital artery (OA) to the posterior pericallosal artery. A 59-year-old man presented with acute-onset headache, and computed tomography revealed subarachnoid hemorrhage and intracerebral hemorrhage at the splenium of the corpus callosum with intraventricular hemorrhage. Digital subtraction angiography demonstrated a ruptured aneurysm located at a transdural anastomotic artery from the right OA to the posterior pericallosal artery. The patient underwent endovascular treatment for the aneurysm through the transdural anastomotic artery with a coil and n-butyl-2-cyanoacrylate. Because it was impossible to navigate a microcatheter to the aneurysm through the right anterior cerebral artery because of the occlusion of its proximal portion, it was advanced through the transdural anastomosis from the right OA. The aneurysm was completely occluded without complications. Endovascular embolization is a useful treatment option for a peripheral cerebral aneurysm developed at a collateral vessel with intracranial major artery occlusion.

The Guglielmi Detachable Coil “Crescent” in the Endovascular Treatment of Peripheral Brain Aneurysms: Technical Case Report

2007 ◽  
Vol 61 (suppl_5) ◽  
pp. ONSE295-ONSE296
Author(s):  
Guido Guglielmi ◽  
Fernando Vinuela ◽  
Giulio Guidetti ◽  
Mauro Dazzi
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Arteries ◽  
Parent Artery ◽  
Parent Vessel ◽  
Detachable Coil ◽  
Vessel Occlusion ◽  
Guglielmi Detachable Coil ◽  
Limited Experience ◽  
Parent Vessel Occlusion ◽  
Brain Aneurysms

Abstract Objective: Peripheral brain aneurysms arise from the distal segments of cerebral arteries. They can be treated by surgery or by an endovascular approach. We present our experience of endovascular treatment of peripheral brain aneurysms with a novel endovascular device, the Guglielmi detachable coil (GDC) “crescent.” Methods: The GDC “crescent” is a 5-mm long, curved coil steerable beyond the tip of a microcatheter and detachable at a distance. The GDC “crescent” was used in three cases of intracranial peripheral aneurysms to occlude their parent vessel. Results: Three peripheral brain aneurysms in three patients were successfully treated with parent vessel occlusion using the prototype GDC “crescent” coils, thereby excluding the aneurysms from the brain circulation. No complications were encountered. Conclusion: From this limited experience, the GDC “crescent” seems particularly suitable for the controlled endovascular occlusion of the often-narrow parent artery of distal brain aneurysms.

scholarly journals Endovascular Treatment of Ruptured Anterior Communicating Artery Aneurysms

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 61-66
Author(s):  
Y. Nakai ◽  
M. Sonobe ◽  
N. Kato ◽  
S. Okamoto ◽  
K. Nakamura ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Medical Center ◽  
Thromboembolic Complication ◽  
Anterior Communicating Artery ◽  
Rotational Angiography ◽  
Effective Technique ◽  
Detachable Coil ◽  
Microsurgical Clipping ◽  
Guglielmi Detachable Coil ◽  
Important Diagnostic Tool

The aim of this paper is to provide a review of our experience in using the endovascular treatment of ruptured anterior communicating artery (ACoA) aneurysms. Between March 1997 and May 2004, 211 ruptured aneurysms were treated with Guglielmi detachable coil (GDC) system in Mito Medical Center, 73 were located at the ACoA. Two cases were incomplete embolization, and performed microsurgical clipping. In the initial embolization for the 71 aneurysms, complete occlusion was achieved in 44 aneurysms, neck remnant in 11 aneurysms and body filling in 16 aneurysms. Intra-operative complication was occurred in six cases (8.2%). Aneurysm perforation was occurred in three cases (4.1%), thromboembolic complication was occurred in three cases (4.1%). Acute rebleeding were observed in two cases (2.7%). Endovascular treatment is an effective technique for treating ACoA aneurysms, and 3D-rotational angiography is important diagnostic tool for evaluating the ACoA complex.

scholarly journals Coil placement after clipping: endovascular treatment of incompletely clipped cerebral aneurysms

1996 ◽  
Vol 1 (3) ◽  
pp. E2
Author(s):  
Michael Forsting ◽  
Friedrich K. Albert ◽  
Olav Jansen ◽  
Rüdiger von Kummer ◽  
Alfred Aschoff ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Aneurysms ◽  
Surgical Clipping ◽  
Detachable Coil ◽  
Complete Occlusion ◽  
Guglielmi Detachable Coil ◽  
Complete Obliteration ◽  
Endovascular Approach ◽  
Good Treatment Option ◽  
Platinum Coils

In up to 4% of patients whose aneurysms are microsurgically clipped, there is an expected or unexpected aneurysm residuum. The authors describe two patients in whom surgical clipping did not result in complete obliteration of the aneurysm sac and in whom a second operation was not believed to be the solution to the problem. In both patients complete occlusion of the aneurysm residuum was achieved via an endovascular approach. Using the Guglielmi detachable coil system, it was possible to place two platinum coils selectively into the aneurysms. The endovascular approach may be a good treatment option for all patients in whom surgical clipping does not result in complete obliteration of the aneurysm sac and reoperation is contraindicated or unacceptable to the patient.

Endovascular treatment of multiple intracranial aneurysms by using Guglielmi detachable coils

1999 ◽  
Vol 90 (5) ◽  
pp. 857-864 ◽  
Author(s):  
Sten Solander ◽  
Alexandre Ulhoa ◽  
Fernando Viñuela ◽  
Gary R. Duckwiler ◽  
Y. Pierre Gobin ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Mass Effect ◽  
Detachable Coil ◽  
Content Type ◽  
Multiple Intracranial Aneurysms ◽  
Unruptured Aneurysms ◽  
Guglielmi Detachable Coil ◽  
Detachable Coils ◽  
Fine Print

Object. The purpose of this paper is to present the authors' experience with Guglielmi detachable coil (GDC) embolization of multiple intracranial aneurysms and to evaluate the results of this therapy in single-stage procedures.Methods. Clinical and angiographic evaluations were performed in 38 consecutive patients with multiple intracranial aneurysms treated by GDC embolization between March 1990 and October 1997. Twenty-nine patients presented with subarachnoid hemorrhage (SAH), four with mass effect, and five were asymptomatic. These 38 patients harbored 101 aneurysms, 79 of which were treated with GDCs, 14 by surgical clipping, and eight were left untreated. Of the GDC-treated lesions, a complete endovascular occlusion was achieved in 55 aneurysms (70%), and 24 (30%) presented neck remnants. Twenty-five patients (66%) underwent GDC embolization of more than one aneurysm in the first session. Eighteen (86%) of 21 patients with acute SAH underwent treatment for all aneurysms within 3 days after admission (15 of 21 in one session). Follow-up angiographic studies in 30 patients demonstrated an unchanged or improved result in 94% of the aneurysms (59 lesions) and coil compaction in 6% (four lesions). The overall clinical outcome was excellent in 34 patients (89%), good in one (3%), fair in one (3%), and death in two (5%).Conclusions. Endovascular treatment of multiple intracranial aneurysms, regardless of their location, with GDCs was performed safely in one session, even during the acute phase of SAH. Treatment of all aneurysms in one session protected the patient from rebleeding and eliminated the risk of mistakenly treating only the unruptured aneurysms.

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