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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Endovascular treatment of unruptured cerebral aneurysms using Guglielmi detachable coils

Endovaskuläre Behandlung von nicht-rupturierten zerebralen Aneurysmen mit Platinspiralen

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  • corresponding author Harald Standhardt - Universitätsklinik für Neurochirurgie, Allgemeines Krankenhaus der Stadt Wien, Wien /A
  • A. Gruber - Universitätsklinik für Neurochirurgie, Allgemeines Krankenhaus der Stadt Wien, Wien /A
  • B. Richling - Universitätsklinik für Neurochirurgie, Allgemeines Krankenhaus der Stadt Wien, Wien /A
  • G. Bavinzski - Universitätsklinik für Neurochirurgie, Allgemeines Krankenhaus der Stadt Wien, Wien /A

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.08.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0229.shtml

Published: April 23, 2004

© 2004 Standhardt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

Endovascular embolisation of intracranial aneurysms using Guglielmi electrolytically detachable coils (GDC) is a treatment option to microsurgical clipping. We report our results with this technique in the treatment of unruptured aneurysms.

Methods

Since February 1992 176 unruptured aneurysms (ACI 77, ACA 5, ACoA 24, MCA 33, BA 26, VA 7, PCA 4) in 155 patients were treated at the Vienna General Hospital using GDCs. The mean age of the treated patients was 52 ± 11 yrs (range 26 to 76 yrs), there were 43 male and 112 female patients. 25 % of patients had a previous SAH from another aneurysm, 15 % became symptomatic due to mass effect, in all other patients (60 %) the aneurysm was found incidentally. Clinical follow-up is available from 95 % of the patients.

Results

Almost all patients had an excellent outcome. There was a low procedure related permanent morbidity, there was no treatment related mortality. The most frequent complication were thromboembolic events during the intervention (11.4 %), from these 3 patients (1.7 %) suffered a stroke (2 mild / 1 severe disability), the other patients kept asymptomatic or had a TIA (7.4 %), 1.1 % had a PRIND. Aneurysm perforation with the guide wire during intervention occurred in 2 patients resulting in SAH in one, both patients recovered without neurological deficit. In another patient (0.57%) the aneurysms ruptured during embolisation leading to relevant neurological disability. In 3 patients with a partially thrombosed giant aneurysm palliative GDC embolisation could not prevent them from later aneurysm rupture, otherwise there was no aneurysm rupture in all other patients in the follow-up period to our knowledge so far. In 12.5 % of patients a re-embolisation was performed, in 4.5 % sufficient obliteration could not be achieved and subsequent microsurgical clipping was done.

Conclusions

We feel that GDC embolisation of unruptured aneurysms is a safe procedure with low intervention related morbidity. It seems to give good protection against future SAH, long-term follow-up studies will have to confirm this.