Document Detail


Gross and microscopic histopathological findings in aneurysms of the human brain treated with Guglielmi detachable coils.
MedLine Citation:
PMID:  10433317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The histopathological characteristics of aneurysms obtained at autopsy or surgery 3 days to 54 months after being treated with Guglielmi detachable coils (GDCs) were assessed. METHODS: Seventeen aneurysms were obtained at autopsy and one was removed at surgery. Fourteen were examined histologically with the coils in situ. Naked coils embedded in an unorganized thrombus were found in those aneurysms that had been treated with coils within 1 week earlier. An incomplete replacement of the intraluminal blood clot by fibrous tissue and a partial membranous covering at the aneurysm orifice were observed in those aneurysms that had been treated with coils between 2 and 3 weeks prior to examination. One small aneurysm treated 6 weeks before harvesting showed formation of an endothelium-lined layer of connective tissue at the orifice. Collagen-rich vascularized tissue surrounding the coils was found in an aneurysm removed at surgery 54 months after coil implantation. Interestingly, six (50%) of 12 aneurysms (two small, three large, and one giant) that had been deemed 100% occluded on initial angiography showed tiny open spaces between the coils at the neck on gross examination. CONCLUSIONS: Endothelialization of the aneurysm orifice following placement of GDCs can occur; however, it appears to be the exception rather than the rule. In large aneurysms the process of intraaneurysm clot organization seems to be delayed and incomplete; tiny open spaces between the coils and an incomplete membranous covering in the region of the neck are frequently encountered. Further longitudinal studies are required to establish the spectrum of healing profiles that may direct our efforts in modifying the GDC system to produce a more stable long-term result.
Authors:
G Bavinzski; V Talazoglu; M Killer; B Richling; A Gruber; C E Gross; H Plenk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  91     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-08-16     Completed Date:  1999-08-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  284-93     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Institute for Histology and Embryology, University of Vienna, Austria.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cerebral Angiography
Collagen
Connective Tissue / pathology
Embolization, Therapeutic / instrumentation*,  methods
Endothelium, Vascular / pathology
Female
Fibrin
Fibroblasts / pathology
Fibrosis
Follow-Up Studies
Humans
Intracranial Aneurysm / pathology,  radiography,  therapy*
Longitudinal Studies
Macrophages / pathology
Male
Middle Aged
Surface Properties
Thrombosis / pathology
Wound Healing
Chemical
Reg. No./Substance:
9001-31-4/Fibrin; 9007-34-5/Collagen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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