Guglielmi Detachable Coil embolization of cerebral aneurysms: 11 years' experience

Abstract

The clinical and postembolization outcomes in patients treated with the GDC system have improved in the past 5 years. Aneurysm recanalization, however, is still a major limitation of current GDC therapy. Follow-up angiography is mandatory after GDC embolization of cerebral aneurysms. Further technical and device improvements are mandatory to overcome current GDC limitations.

Adenosine-Induced Transient Asystole

“…9,10 The Cerebral Aneurysm Re-rupture After Treatment (CARAT) study found a rate of rupture after treatment to be 1.8%, which is comparable to the 1.7% rerupture rate reported earlier in the International Subarachnoid Aneurysm Treatment study. 11 Recently, their subtotal occlusion cohort study of 1,010 patients treated with coil embolization or surgical clipping found that degree of occlusion was associated with a lower risk of rerupture.…”

“…[10][11][12] This recanalization, however, was found to be associated with larger aneurysms and those with a poor dome-to-neck ratio. 10 Despite the fact that microsurgical clipping provides a far superior anatomic cure compared to endovascular coiling, coiling has been shown to be effective in changing the natural history of unruptured and ruptured aneurysms as well. Therefore, complete anatomic cure is not required to change the natural history of cerebral aneurysms.…”

Flow diverter effect on cerebral aneurysm hemodynamics: an in vitro comparison of telescoping stents and the Pipeline

“…Endovascular treatments such as coil embolization have been used more frequently in recent years, not only because they are less invasive than surgical techniques, but also because they are more effective [3][4][5]. Unfortunately, recurrence rates for large aneurysms can be as high as 50% after embolic coling [6]. Such frequent recurrence demonstrates a clear need for improved coil embolization techniques and/or for other endovascular approaches to cerebral aneurysm treatment.…”

Angiographic analysis of blood flow modification in cerebral aneurysm models with a new asymmetric stent

“…A common endovascular treatment of aneurysms uses filling the aneurysm with Guglielmi detachable coils (GDC coils). 1 , 2 During the treatment of an aneurysm using coils, physicians use x-ray angiograms to determine the packing of coils in the aneurysm body and the extent of unpacked neck remnant 1 , 2 as a means to evaluate the results of the treatment. However, problems may occur when using GDC coils to fill the aneurysm, such as, possible herniation of coil into the main vessel, incomplete filling of the neck of the aneurysm followed by re-growth, difficulties in dealing with wide neck aneurysms and giant aneurysms.…”