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Long-term histopathologic findings in two cerebral aneurysms embolized with Guglielmi detachable coils
E Castro1, F Fortea, F Villoria
1Section of Neuroradiology, Hospital General Universitario Gregorio Marañon, Madrid, Spain.
Insights
Autopsy revealed Guglielmi detachable coils (GDCs) firmly attached to aneurysmal walls 33 months post-treatment. This firm attachment prevented coil removal, indicating long-term integration within the treated cerebral aneurysms.
Area of Science:
- Neurology
- Pathology
- Medical Devices
Background:
- Cerebral aneurysms pose significant risks, necessitating effective treatment options.
- Guglielmi detachable coils (GDCs) are a common endovascular treatment for cerebral aneurysms.
- Long-term outcomes and tissue integration of GDCs require detailed pathological examination.
Observation:
- A patient treated with GDCs for two aneurysms died 33 months post-procedure.
- Gross pathologic and histologic examination of the treated aneurysms were performed.
- GDCs were found to be firmly attached to the aneurysmal walls in both treated sites.
Findings:
- The firm attachment of GDCs to the aneurysmal wall made them impossible to remove.
- Collagenous tissue and a single layer of endothelium covered the ostium of one treated aneurysm.
- Histologic findings suggest significant tissue integration and remodeling around the GDCs over time.
Implications:
- The findings highlight the permanent nature of GDC placement and the potential for tissue integration.
- Understanding long-term GDC behavior is crucial for managing patients with treated aneurysms.
- This case provides valuable insights into the tissue response to endovascular coil embolization for cerebral aneurysms.
Abstract:
We present gross pathologic autopsy findings of a patient who was treated for two aneurysms with Guglielmi detachable coils (GDCs), and who died 33 months after the procedure. Histologic findings are also presented. In both aneurysms, the coils were firmly attached to the aneurysmal wall, making it impossible to remove them from the sac. The ostium of one aneurysm was covered by collagenous tissue and a single layer of endothelium.