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Endovascular Treatment of Pseudoaneurysms with Electrolytically Detachable Coils

1998; American Society of Neuroradiology; Volume: 19; Issue: 5 Linguagem: Inglês

1936-959X

Todd E. Lempert, V V Halbach, Randall T. Higashida, Christopher F. Dowd, Ross W. Urwin, Peter A. Balousek, Grant B. Hieshima,

Moyamoya disease diagnosis and treatment

PURPOSE: We describe the clinical presentation, angiographic findings, and clinical outcome in a group of patients with pseudoaneurysms treated by a new endovascular technique using Guglielmi electrolytically detachable platinum coils (GDCs). METHODS: We retrospectively reviewed the angiographic and clinical findings in a series of 11 patients with pseudoaneurysms occurring in a variety of locations: seven in the cavernous carotid artery, one in the petrous carotid artery, two in the anterior cerebral artery, and one in the cervical vertebral artery. RESULTS: All aneurysms were cured with GDC embolization. The only complication was a branch occlusion, which resolved with heparinization and produced no clinical sequelae. CONCLUSION: Pseudoaneurysms can be safely and effectively treated by embolization with GDCs. Consideration needs to be given to the anatomic location of the pseudoaneurysm and the acuity of onset. Treatment efficacy may by improved if there are bony confines around the aneurysm or if therapy takes place in the subacute period, when the wall of the pseudoaneurysm has matured and stabilized. Pseudoaneurysms of intracranial and neck vessels are a well-described entity. They can carry a high rate of morbidity and mortality and, depending on their location, be extremely difficult to treat by surgical means without sacrificing the parent artery. With the advent of Guglielmi electrolytically detachable coils (GDCs; Target Therapeutics, Fremont, Calif), some of these pseudoaneurysms have become amenable to treatment via an endovascular approach. We report the safety and efficacy of this technique in 11 patients with pseudoaneurysms treated with GDC embolization over the past 3 years.