This retrospective analysis was undertaken to evaluate a possible relationship between coil packing density and coil compaction on intracranial aneurysms embolized using Guglielmi detachable coils (GDCs). Of the patients who underwent endovascular surgery using GDC in our hospital between 1994 and 1998, 33 patients had endovascular treatment with GDC and were examined by follow-up angiography at least 12 months after surgery. They had coil embolization to the extent where aneurysms were no longer filled or only faintly filled as shown by cerebral angiography immediately after surgery. At follow-up angiography, coil compaction was observed in 3 aneurysms. In all patients with coil compaction, the coil packing density was below 20% (14.5 +/- 4.0%). On the other hand, it was over 20% (25.7 +/- 4.7%) in all patients without coil compaction. In the 11 patients with a basilar bifurcation aneurysm, the coil packing density was over 24% and no coil compaction was observed. The coil packing density seems to be one of the critical factors, particularly for predicting whether or not coil compaction will occur. Endovascular surgery should be performed to obtain coil packing density higher than 20%.
Sixteen patients with symptomatic dural caroticocavernous fistulae were treated by transvenous embolization, via the jugular vein and inferior petrosal sinus. The fistula was occluded by thrombogenic coils. Complete resolution of symptoms and signs was achieved in 14 patients, and complete angiographic resolution was also obtained in 14 patients. Failures to achieve angiographic cure were attributed to failure to reach the fistula within the cavernous sinus precisely. Factors which make placement of the catheter at the fistula difficult are trabeculae within the cavernous sinus, a specific configuration of the superior ophthalmic vein and venous thrombosis. To improve the efficacy of transvenous embolization, every possible venous route to the cavernous sinus therefore should be tried, to facilitate reaching the fistula and the possibility of transvenous embolization should not be thwarted by venous thrombosis.
The low concentration of NBCA induced a tissue response similar to that of the high-concentration form. Embolized vessels exhibited no greater incidence of recanalization. Therefore, embolization of arteriovenous malformations with diluted NBCA may be safe.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.