Document Detail


Guglielmi detachable coil embolization of cerebral aneurysms: 11 years' experience.
MedLine Citation:
PMID:  12744354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The authors report on their 11 years' experience with embolization of cerebral aneurysms using Guglielmi Detachable Coil (GDC) technology and on the attendant anatomical and clinical outcomes. METHODS: Since December 1990, 818 patients harboring 916 aneurysms were treated with GDC embolization at University of California at Los Angeles Medical Center. For comparative purposes, the patients were divided into two groups: Group A included their initial 5 years' experience with 230 patients harboring 251 aneurysms and Group B included the later 6 years' experience with 588 patients harboring 665 aneurysms. Angiographically demonstrated complete occlusion was achieved in 55% of aneurysms and a neck remnant was displayed in 35.4% of lesions. Incomplete embolization was performed in 3.5% of aneurysms, and in 5% occlusion was attempted unsuccessfully. A comparison between the two groups revealed a higher complete embolization rate in patients in Group B compared with that in Group A patients (56.8 and 50.2%, respectively). The overall morbidity/mortality rate was 9.4%. Angiographic follow ups were obtained in 53.4% of cases of aneurysms, and recanalization was exhibited in 26.1% of aneurysms in Group A and 17.2% of those in Group B. The overall recanalization rate was 20.9%. Note that recanalization was related to the size of the dome and neck of the aneurysm. Overall incidence of delayed aneurysm rupture was 1.6%, a rate that improved in the past 5 years to 0.5%. Ten of 12 delayed ruptures occurred in large or giant aneurysms. CONCLUSIONS: 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.
Authors:
Yuichi Murayama; Yih Lin Nien; Gary Duckwiler; Y Pierre Gobin; Reza Jahan; John Frazee; Neil Martin; Fernando Viñuela
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  98     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-14     Completed Date:  2003-06-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  959-66     Citation Subset:  AIM; IM    
Affiliation:
Division of Interventional Neuroradiology and Neurosurgery, University of California Medical Center, David Geffen School of Medicine at the University of California, Los Angeles, California 90095-1721, USA. ymurayama@mednet.ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Ruptured / radiography,  therapy*
Angioplasty, Balloon / instrumentation
Cerebral Angiography
Embolization, Therapeutic / instrumentation*
Equipment Design
Female
Follow-Up Studies
Humans
Intracranial Aneurysm / radiography,  therapy*
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Recurrence
Retrospective Studies
Subarachnoid Hemorrhage / radiography,  therapy*
Comments/Corrections
Comment In:
J Neurosurg. 2003 May;98(5):945-7; discussion 947   [PMID:  12744351 ]

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


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