Document Detail


Causes and management of aneurysmal hemorrhage occurring during embolization with Guglielmi detachable coils.
MedLine Citation:
PMID:  9647177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The purpose of this review is to describe the incidence, causes, management, and outcome of aneurysmal hemorrhage that occurred in patients during endovascular treatment with the Guglielmi detachable coil (GDC) system. METHODS: At the authors' institution between September 1991 and August 1995, more than 200 patients were treated using GDCs for intracranial aneurysms. The first 200 patients treated in this fashion were reviewed and all who experienced new subarachnoid hemorrhage (SAH) during the procedure were identified. Angiographic studies were also reviewed and patients were contacted for longer-term follow up when possible. Four patients who experienced intraprocedural SAH were identified. The causes of hemorrhage were believed to be perforation of the aneurysm by the guidewire in one patient, perforation by the microcatheter in a second, and perforation by the delivery wire in a third. The fourth patient had a hemorrhage during injection of contrast material for control angiographic studies after placement of the final coil. One patient died, but the other three experienced no neurological symptoms or recovered without acquiring additional deficits. Overall a procedural hemorrhage rate of 2% was seen, with permanent morbidity and mortality rates of 0% and 0.5%, respectively. CONCLUSIONS: Although SAH during endovascular treatment of intracranial aneurysms remains a significant risk, its incidence is low and a majority of patients can survive without serious sequelae.
Authors:
C G McDougall; V V Halbach; C F Dowd; R T Higashida; D W Larsen; G B Hieshima
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  89     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-07-15     Completed Date:  1998-07-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  87-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, University of California at San Francisco Medical Center, USA. CMcDougall@theBNI.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, Ruptured / etiology
Cause of Death
Cerebral Angiography / adverse effects
Cerebral Arteries / injuries
Contrast Media / adverse effects
Embolization, Therapeutic / adverse effects,  instrumentation*,  methods
Equipment Design
Female
Follow-Up Studies
Headache / etiology
Humans
Incidence
Intracranial Aneurysm / pathology,  therapy*
Intracranial Arteriovenous Malformations / therapy
Male
Middle Aged
Risk Factors
Subarachnoid Hemorrhage / etiology*,  therapy
Treatment Outcome
Chemical
Reg. No./Substance:
0/Contrast Media

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