Intravascular Neurosurgery for Cerebral Aneurysm Using Interlocking Detachable Coils

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 149-153 ◽  
Author(s):  
A. Hyodo ◽  
Y. Matsumaru ◽  
I. Anno ◽  
H. Sato ◽  
N. Kato ◽  
...  
Keyword(s):  
Cerebral Aneurysm ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Parent Artery ◽  
Detachable Coil ◽  
Intraoperative Bleeding ◽  
Poor Grade ◽  
Guglielmi Detachable Coil ◽  
Detachable Coils ◽  
Proximal Occlusion

Instead of the Guglielmi detachable coil (GDC; Target Therapeutics, Fremont, California), the interlocking detachable coil (IDC; Target Therapeutics, Fremont, California) was the only available detachable and retractable coil in Japan until February 1997. From October 1993 to February 1997, endovascular treatment with IDCs were attempted for 25 cases of cerebral aneurysm. Within 25 trials, 15 cases were treated by intra-aneurysmal coil embolization, 9 cases by parent artery or proximal occlusion using IDCs and one case could not be treated due to anatomical problems of the aneurysm. As for 15 cases of intra-aneurysmal coil packing, complete occlusion was performed in 9 cases, subtotal occlusion in 4 cases and partial occlusion in 2 cases. In one of the partial occluded cases, a coil compaction occurred 6 months after embolization. Distal emboli were recognized on CT after embolization in 3 cases, however, only one case was symptomatic. Intraoperative bleeding occurred in one case, but no obvious hemorrhage after coil embolization in any case. From our experiences, treatment for poor-grade ruptured aneurysm is still difficult, but intravascular surgery for cerebral aneurysms using IDC is possible and a useful alternative, especially for surgically difficult aneurysm.

scholarly journals Lyophilizing thrombin powder-based treatment for hemostasis during coil embolization of ruptured cerebral aneurysm: Two case reports

2019 ◽  
Vol 25 (4) ◽  
pp. 454-459
Author(s):  
Changchun Jiang ◽  
Wei Wang ◽  
Baojun Wang ◽  
Yuechun Li ◽  
Guorong Liu ◽  
...  
Keyword(s):  
Cerebral Aneurysm ◽  
Coil Embolization ◽  
Case Reports ◽  
Balloon Catheter ◽  
Treatment Strategies ◽  
Cerebral Aneurysms ◽  
Interventional Therapy ◽  
Parent Artery ◽  
Clinical Practices ◽  
Detachable Coils

Background Rupture of cerebral aneurysm is an inevitable complication during embolization, followed by subsequent acute subarachnoid hemorrhage or intracranial hematoma, and results in the aggravation of a patient’s condition. In particular, for patients who have had a ruptured aneurysm, urgent treatment strategies are required during operation. The most common hemostatic methods seen in clinical practices are as follows: after lowering the blood pressure, we continue to embolize the aneurysms with detachable coils as soon as possible or inject with Glubran/Onyx embolization liquids, as well as use a balloon catheter to temporarily block the blood supply. If the conditions are permissible, a balloon guiding catheter may even be used to restrict the proximal blood flow. At times, due to limitations of these methods, neurosurgeons are requested to perform craniotomy to treat the hemostasis. However, the delayed transition often leads to rapid deterioration of the patient’s condition and even death due to cerebral hernia. Case description We herein presented two cases of ruptured cerebral aneurysms to provide an alternative method for hemostasis and to save the lives of patients as much as possible. In an extremely urgent situation (conventional treatment is ineffective), we successfully saved the patient’s life by injecting lyophilizing thrombin powder (LTP) solution into the aneurysmal sac and the parent artery through a microcatheter. Conclusions To our knowledge, this is the first report of successful hemostasis during coil embolization of ruptured cerebral aneurysm with LTP. Further prospective studies are needed to confirm the safety and efficacy of LTP in cerebrovascular interventional therapy.

Intra-Aneurysmal Embolization for the Treatment of Cerebral Aneurysms Using Detachable Coils

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 67-69 ◽  
Author(s):  
A. Hyodo ◽  
N. Kato ◽  
I. Anno ◽  
H. Sato ◽  
T. Nose ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Minor Stroke ◽  
Detachable Coil ◽  
Complete Occlusion ◽  
Poor Grade ◽  
Results Of Treatment ◽  
Detachable Coils ◽  
Basilar Tip Aneurysm ◽  
Better Than

From October 1993 to February 1998, intraaneurysmal embolization by endovascular treatment with detachable coils was performed for 41 cases of cerebral aneurysm. As a detachable coil, interlocking detachable coils (IDC) were used in the initial 15 cases and Guglielmi detachable coils (GDC) were used in the subsequent 26 cases. As for 15 cases treated with IDC, complete occlusion was performed in 9 cases, subtotal occlusion in 4 cases and partial occlusion in 2 cases. In one of the partial occluded cases, a coil compaction occurred 6 months after embolization. Distal emboli were recognized on CT after embolization in 3 cases, however, only one case was symptomatic. Intra-operative bleeding occurred in one case, but no obvious hemorrhage after coil embolization in any case. As for 26 cases treated with GDC, complete occlusion was performed in 18 cases, subtotal occlusion in 8 cases. In one case of basilar-tip aneurysm, a mild coil compaction occurred 6 months after embolization. Distal emboli were recognized on CT after embolization in 3 cases, however, only one case was symptomatic (minor stroke). No intra-operative bleeding and no obvious hemorrhage after coil embolization occurred in any case. From our experiences, treatment for poor-grade ruptured aneurysm is still difficult, but intra-aneurysmal embolization for cerebral aneurysms using detachable coils is possible and a useful alternative, especially for surgically difficult aneurysms. The results of treatment of aneurysm with GDC are much better than those with IDC, so the indications for intra-aneurysmal embolization with GDC might increase in the future.

scholarly journals Retreatment of Cerebral Aneurysms after Guglielmi Detachable Coil Embolization

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 167-171 ◽  
Author(s):  
Y Matsumaru ◽  
H Sato ◽  
T Takigawa ◽  
M Okazaki ◽  
T Kamezaki ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Parent Artery ◽  
Detachable Coil ◽  
Technical Improvement ◽  
Guglielmi Detachable Coil ◽  
Surgical Clip ◽  
Embolic Agents ◽  
Detachable Coils ◽  
Additional Therapy

Of 175 patients with 181 aneurysms initially treated with Guglielmi Detachable Coils (GDC), 25 were retreated. All retreatments except one were performed on previously ruptured aneurysms. Thirteen aneurysms were retreated because of recurrence, and 12 aneurysms were retreated to complete initial insufficient embolization. Sixteen patients underwent re-embolization and 9 patients were operated upon surgically. No complications related to the retreatment were experienced. We consider that repeat embolization should be attempted before considering surgical treatment in case that additional therapy is required. However, it is difficult to retreat aneurysms having wide necks. In regard to surgical clipping, aneurysms without a coil in the neck are easier to treat with primary clipping, whereas aneurysms with a coil mass in the neck are difficult to surgical clip. We have never used temporary clipping and coil extraction if the distance between the coil and the parent artery was wider than 2 mm. Emerging new embolic agents or devices and technical improvement might decrease the need for retreatment and increase long-term efficacy after endovascular treatment.

Endovascular Treatment Using Detachable Coils for Non-Ruptured Intracranial Aneurysm

1999 ◽  
Vol 5 (1_suppl) ◽  
pp. 67-70 ◽  
Author(s):  
K. Satoh ◽  
J. Satomi ◽  
N. Nakajima ◽  
S. Nagahiro
Keyword(s):  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Morbidity Rate ◽  
Detachable Coil ◽  
Ruptured Intracranial Aneurysm ◽  
Detachable Coils ◽  
Angiographic Examination ◽  
Ischemic Attack ◽  
Age Range ◽  
Coil Migration

Detachable coil embolization was performed on 34 non-ruptured cerebral aneurysms in 33 patients. Patients consisted of 28 females and five males, with an age range of 26 to 77 years. Angiographic examination after coil embolization revealed complete or near-complete occlusion in 24 aneurysms (70.5%) and partial occlusion in three (8.8%). Detachable coil embolization was attempted unsuccessfully in seven aneurysms (20.5%). Transient ischemic attack occurred in one case with coil migration. The combined mortality/morbidity rate was 0%.

scholarly journals Successful Transarterial Guglielmi Detachable Coil Embolization of Post-Traumatic Fistula between a Posterior Communicating Artery Aneurysm and the Cavernous Sinus

2009 ◽  
Vol 15 (4) ◽  
pp. 435-441 ◽  
Author(s):  
Y. Chen ◽  
D-Y. Jiang ◽  
H-Q. Tan ◽  
L-H. Wang ◽  
X-Y. Chen ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Coil Embolization ◽  
Rare Complication ◽  
Craniocerebral Trauma ◽  
Artery Aneurysm ◽  
Posterior Communicating Artery ◽  
Detachable Coil ◽  
Guglielmi Detachable Coil ◽  
Detachable Coils ◽  
Post Traumatic

We describe a case of a post-traumatic posterior communicating artery (PCoA) aneurysmcavernous sinus fistula, which is an extremely rare complication of craniocerebral trauma, successfully treated with endosaccular coil embolization via transarterial route. Endosaccular embolization with Guglielmi detachable coils via transarterial route appears to be a feasible, effective and minimally invasive option for the treatment of post-traumatic fistula between the PCoA aneurysm with a small ostia and the cavernous sinus in the subacute phase.

scholarly journals The Efficacy of Coil Embolization at the Dissection Site of Ruptured Dissecting Vertebral Aneurysms

2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 73-82 ◽  
Author(s):  
A. Kurata ◽  
M. Yamada ◽  
T. Ohmomo ◽  
H. Hirayama ◽  
S. Suzuki ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Balloon Occlusion ◽  
Parent Artery ◽  
Vertebral Arteries ◽  
Coil Occlusion ◽  
Platinum Coil ◽  
Detachable Coils ◽  
Proximal Occlusion ◽  
Dissecting Aneurysms

Proximal occlusion of the parent artery has been widely used for treatment of vertebral dissecting ruptured aneurysms, but this does not always completely prevent re-rupture. In this series, the efficacy of occlusion at the dissection site using detachable coils was compared with proximal balloon occlusion. Over a five year period, 25 patients suffering from subarachnoid hemorrhage with dissecting vertebral aneurysms were treated by endovascular surgery. The first three of these 25 patients were treated with proximal balloon occlusion of the parent artery. The remainder underwent platinum coil occlusion at the affected site as early as possible after the diagnosis. In two of the three cases treated with proximal balloon occlusion, clipping or coating surgery were added because of progressive dissection. In all 22 cases of coil embolization, the intervention was successfully performed without complication. In one case with a dissection involving bilateral vertebral arteries, minor rebleeding from a contralateral dissection occurred after embolization. In the other 21 cases, rebleeding was not apparent (clinical follow-up: mean 24 months). Radiological findings showed complete occlusion of the dissection site and patency of the non affected artery (follow-up: mean ten months). We conclude that detachable platinum coil embolization at the dissection site is more effective than proximal occlusion for treatment of ruptured vertebral dissecting aneurysms because of immediate cessation of blood flow to the dissection site. However, in cases with bilateral dissections or hypoplastic contralateral vertebral arteries, preceding bypass surgery or stent treatment to preserve the affected vertebral artery may be needed.

Coil Embolization of Cerebral Aneurysms

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 159-164
Author(s):  
S. Nemoto ◽  
J. Iwama ◽  
Y. Mayanagi ◽  
T. Kirino
Keyword(s):  
Clinical Outcome ◽  
Cerebral Aneurysm ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Detachable Coil ◽  
Occlusion Rate ◽  
Platinum Coils

Coil embolization was performed in 86 cerebral aneurysm patients using two types of detachable platinum coils, IDC (Interlocking detachable coil) and GDC (Guglielmi electrical detachable coil). Results of IDC and GDC were compared. The occlusion rate of the aneurysm sac was similar. Coil compaction occurred frequent and early in cases with GDC. As clinical outcome, 94% of the patients in both group obtained good results. No bleeding or rebleeding occurred in the follow-up with IDC or GDC.

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.

scholarly journals 2D Fast Spoiled Gradient Echo (2D-FSPGR) Gd-DTPA Enhanced Dynamic MR Angiography in Cerebral Aneurysms after Treatment with Platinum Detachable Coils

2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 65-72 ◽  
Author(s):  
T. Hayashi ◽  
J. Asai ◽  
H. Sugimoto ◽  
M. Honda ◽  
K. Satoh ◽  
...  
Keyword(s):  
Mr Angiography ◽  
Cerebral Aneurysms ◽  
Arterial Phase ◽  
Parent Artery ◽  
Residual Flow ◽  
Tof Mra ◽  
First Pass ◽  
Platinum Coil ◽  
Detachable Coils ◽  
Artery Flow

The purpose of this study is to evaluate the perfusional state of cerebral aneurysms treated by platinum detachable coils using three different techniques of MR angiography (MRA), and to compare the results of each MRA technique. Thirty examinations were investigated in twelve patients. They were three men and nine women, and their average age was 67y.o. They were all treated by platinum detachable coils for cerebral aneurysms. We obtained three different types of MRA on the same day; 2D-FSPGR Gd-DTPA enhanced dynamic MRA, 3D-TOF MRA with and without Gd-DTPA enhancement. On 2D FSPGR enhanced dynamic MRA, we used the first pass arterial phase for judgement that did not overlap the venous phase. In each study, we evaluated parent artery flow, branch artery flow, residual flow in coils, and residual neck. Digital subtraction angiography (DSA) was used as gold standard. On 3D-TOF MRA examinations without enhancement, parent artery flow was correctly identified with an accuracy of 96.7% with DSA confirmation. Branch artery flow was identified with an accuracy of 91.3%. Flow in the coils was correctly identified with an accuracy of 86.7%. Residual neck was correctly evaluated with an accuracy of 83.3%. On 3D-TOF MRA with enhancement, parent artery flow was correctly identified with an accuracy of 96.7%. Branch artery flow was identified with an accuracy of 91.3%. Flow in the coils was correctly identified with an accuracy of 93.3%. Residual neck was correctly identified with an accuracy of 86.7%. On 2D FSPGR enhanced dynamic MRA, parent artery flow was correctly identified with an accuracy of 100%. Branch artery flow was identified with an accuracy of 94.2%. Flow in the coils was correctly identified with an accuracy of 96.7%. Residual neck was correctly evaluated with an accuracy of 100%. Parent artery flow, branch artery flow, residual flow in coils, and residual necks were seen more accurately with 2D-FSPGR Gd-DTPA enhanced dynamic MRA than 3D-TOF MRA with and without enhancement. With T1 shortening effect of Gd-DT-PA and first pass arterial phase of 2D-FSPGR enhanced dynamic MRA techniques, we could evaluate more accurately the perfusional status of platinum-coil-treated cerebral aneurysms and arteries adjacent to the aneurysms than with non enhanced or enhanced 3D TOF MRA.

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