Utility of catheter-assisted Guglielmi detachable coiling in the treatment of wide-necked aneurysms.

Abstract

Catheter-assisted Guglielmi detachable coiling (CAGDC) is a technical option that was developed to allow the endovascular treatment of wide-necked aneurysms. We report upon our experiences of the CAGDC in treating aneurysms with an assessment of its efficacy and safety. The effect of CAGDC of wide-necked aneurysms was retrospectively evaluated in 10 patients (5 females, 5 males, mean age 56, range 40-76 yrs) who underwent the procedure. All the aneurysms were successfully embolized with CAGDC. Eight patients presented with SAH from an acutely ruptured aneurysm. Six patients were available for an angiographic follow up (mean: 10.3 months, range: 6-12 months). At the angiographic follow-up, all the aneurysms were stable and occluded (3 aneurysms with complete and 3 with near complete packing of the sac and neck). Complications directly related to the procedure were encountered in two patients (one coil migration, one thrombo-embolism). Three patients died as a result of complication of subarachnoid hemorrhage. CAGDC is a viable option for the treatment of wide neck aneurysms prior to balloon (or stent) assisted coil embolization.