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Techniques of coiling cerebral aneurysms.

G M Debrun¹, V A Aletich, J Thornton

¹Department of Radiology, University of Illinois at Chicago, 60612, USA.

Surgical Neurology

|March 14, 2000

Summary

Coil embolization is a safe and effective treatment for cerebral aneurysms, offering good outcomes. Technical advancements have improved complete occlusion rates, making coiling a viable alternative to surgery.

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Area of Science:

Neurosurgery
Interventional Radiology
Vascular Neurology

Background:

Over 200 cerebral aneurysms treated with coiling at UIC Medical Center in 5 years.
Coiling is indicated for aneurysms with favorable geometry or difficult surgical access.
Patients medically unfit for surgery are also candidates for coiling.

Purpose of the Study:

To detail technical factors enhancing complete occlusion of cerebral aneurysms via coiling.
To evaluate outcomes and safety of endovascular coiling for cerebral aneurysms.

Main Methods:

Patients treated under general anesthesia with full anticoagulation and paralysis.
Coiling performed using simultaneous biplane roadmapping.
Dense packing of the aneurysm with soft coils of decreasing diameter.

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Main Results:

Morbidity and mortality rates have decreased; morphological outcomes improved with remodeling techniques and advanced materials.
21% incomplete occlusion initially; 1/3 achieved complete occlusion on follow-up.
Stable neck remnants in 1/3 with >95% occlusion; no rebleeding.
Regrowth of neck remnants in <95% occlusion group, necessitating retreatment; overall rebleeding rate <1%.

Conclusions:

Coiling offers low morbidity and mortality.
Good morphological outcomes achieved in most cases.
Coiling is a reasonable alternative to surgical clipping for selected cerebral aneurysms.