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Use of Three-dimensional Guglielmi Detachable Coils in the Treatment of Wide-necked Cerebral Aneurysms

2000; American Society of Neuroradiology; Volume: 21; Issue: 7 Linguagem: Inglês

1936-959X

Harry J. Cloft, Gregory J. Joseph, Frank Tong, Jonas H. Goldstein, Jacques E. Dion,

Moyamoya disease diagnosis and treatment

Summary: A three-dimensional Guglielmi detachable coil (3D-GDC) has been developed that is designed specifically to bridge the neck of an aneurysm with coil loops, thereby facilitating retention of additional coils placed within the aneurysm. Nine wide-necked cerebral aneurysms were successfully embolized using the 3D-GDC, provided that the dome-to-neck ratio was 1.5 or greater. A principal disadvantage of embolization of cerebral aneurysms with Guglielmi detachable coils (GDCs, Target Therapeutics/Boston Scientific Corp, Natick, MA) as compared with surgical clipping is that embolization does not work well for aneurysms that have a wide neck. Complete aneurysmal thrombosis can be achieved in 85% of aneurysms with a neck smaller than 4 mm, but in only 15% of aneurysms with a neck of 4 mm or greater (1). New adjunctive techniques, such as balloon remodeling (2), can increase the rate of successful embolization but incur the cost of increased risk and complexity associated with an additional catheter system. A three-dimensional GDC (3D-GDC) has been developed (Target Therapeutics/Boston Scientific) that is designed specifically to bridge the neck of an aneurysm with coil loops, thereby facilitating retention of additional coils placed within the aneurysm. We report our experience with embolization of nine cerebral aneurysms by use of 3D-GDCs with a spherical configuration.