Treatment of aneurysms with wires and electricity. A historical overview

Abstract

Endovascular treatment of aneurysms has only recently become an accepted therapeutic modality. Nonetheless, treatment of aneurysms with the aid of various foreign bodies such as needle and wire insertion with or without electrical current has been reported since the first half of the 19th century. In 1832 Phillips induced clot formation in the femoral and carotid arteries of dogs by leaving needles in the arteries for variable lengths of time. Simultaneously, in France, Velpeau had proposed using "l'acupuncture des arteres dans le traitement des anevrismes." Later, Phillips and Pelrequin connected the offending needles to a source of electrical current in an attempt to increase thrombus formation and aneurysm occlusion. Subsequently, Moore introduced the concept of packing the aneurysm with wire inserted through a needle transfixed to the vessel wall. To this method, Corradi added electrical current. Widely known as the Moore-Corradi technique, it was used in ensuing years with variable success. The early phase of endovascular aneurysm treatment culminated when Blakemore and Moore treated a case of symptomatic cavernous sinus aneurysm by passing wire through the patient's orbit. These pioneering cases combined with technological advances in the diagnosis of intracranial aneurysms paved the way for further refinements in coil embolization of aneurysms.

Aortic Surgery

“…Fifteen years later, Corradi used the same method but also passed a galvanic current through the wire. 10 Although electrolysis was practiced for several decades, its results were not generally impressive until 1938, when Blakemore and King 11 devised an accurate means for electrothermic coagulation of aneurysms. Meanwhile, in 1903, Colt 12 had pioneered the use of a small wire umbrella, which was inserted through a cannula and then expanded inside the aneurysm―foreshadowing current endovascular therapies.…”

Visceral Artery Aneurysms : Historical Survey. Part 2

“…Для лечения аневризм аорты данная методика была предложена итальянским хирургом Luigi Ciniselli (1803-1878) в 1847 г. Однако эффективность лечения аневризм электротромбозом считалась весьма сомнительной. В 1879 г. другой итальянский хирург Giuseppe Corradi (1830-1907) предложил сочетать метод установки металлической катушки в полость аневризмы с гальванопунктурой, известный как метод Мура-Корради или филипунктура, который активно применялся вплоть до середины прошлого века [24,25].…”

“…Среди паллиативных методов лечения аневризм, недоступных радикальному вмешательству, к которым прибегали врачи второй половины XIX -начала XX века, были и методы химического воздействия. С целью стимулирования образования тромбов и уменьшения аневризматического мешка в полость аневризмы аорты вводили эрготин (экстракт спорыньи), полуторахлористое железо, хлорид цинка, спирт, уксус [25,33], а внутривенно или подкожно -желатин [34,35]. Результаты, полученные от такого лечения, как впрочем и от введения в аневризму проволоки и/или электропунктуры, были крайне неза-видны и зачастую оказывались вредными или опасными для жизни.…”

Endovascular Neurosurgery: A History of Electricity, Balloons, Wires and Glue

“…4,5 One of the techniques being considered was inserting a needle to provoke formation of a clot that would close off the aneurysm. The proof that this technique could work was discovered by C. H. Moore in 1864, during an autopsy of a gunshot victim.…”

“…Attempts using electrical current to provoke clots during this period did not produce a consistent benefit either. 5,6 A large part of the problem was that no one could see where they were going. At that time, aneurysms could only be seen by opening the patient.…”