[Problems involved in endovascular embolization of intracranial aneurysms with three-dimensional Guglielmi detachable...

We experienced nine cases of intracranial aneurysms which were treated with three-dimensional Guglielmi detachable coils (3D-GDC). 3D-GDC is useful in the construction of the initial frame for the embolization of aneurysms, but it also has certain disadvantages for achieving successful treatment. Nine patients with nine intracranial aneurysms were treated with 3D-GDC for initial framing from October, 1999 to September, 2000 at the National Cardio-Vascular Center, Japan. Angiographically complete and successful occlusion was performed in only three patients. Four patients developed parent artery stenosis due to small loops of the 3D-GDC protruding from the aneurysm. Two patients experienced incomplete occlusion because small loops of the 3D-GDC caused cells to form in the framing, and additional coils could not be inserted into some cells. 3D-GDC is useful as an initial framing coil, but we should be careful when placing additional coils into an aneurysm because we cannot predict the effect of the small loops of 3D-GDC on the embolization of aneurysms.