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Published on: November 4, 2021
[Treatment of acute ruptured aneurysm with Guglielmi detachable coil embolization]
Ming Liu1, Xu-ming Hua, Liang Wan
1Department of Neurosurgery, Xinhua Hospital, Shanghai Second Medical University, Shanghai 200092, China.
Insights
Early embolization using Guglielmi detachable coils (GDC) effectively treats acute ruptured intracranial aneurysms with minimal complications. This less invasive approach shows promising results for managing these critical vascular conditions.
Area of Science:
- Neurosurgery
- Interventional Neuroradiology
- Vascular Neurology
Context:
- Acute ruptured intracranial aneurysms pose a significant threat.
- Early intervention is crucial for improving patient outcomes.
- Guglielmi detachable coils (GDC) offer a minimally invasive treatment option.
Purpose:
- To evaluate the efficacy of early GDC embolization for acute ruptured intracranial aneurysms.
- To assess the safety and complication rates associated with GDC treatment.
- To determine the long-term outcomes of this therapeutic strategy.
Summary:
- Retrospective analysis of 34 patients with ruptured intracranial aneurysms treated with early GDC embolization (within 6 days).
- High rates of complete (28/34) and near-complete (4/34) aneurysm occlusion observed via angiography.
- No mortality or major complications reported; no re-ruptures occurred during follow-up.
Impact:
- Early GDC embolization is a safe and effective treatment for acute ruptured aneurysms.
- This method presents a low-risk, less invasive alternative to traditional surgical interventions.
- The findings support GDC embolization as an ideal therapeutic choice for managing ruptured aneurysms.
Objective:
To investigate the curative effect of Guglielmi detachable coil (GDC) on acute ruptured intracranial aneurysms.
Methods:
The clinical data of 34 patients with acute rupture of intracranial aneurysms treated with early GDC embolization within 6 days after the rupture, 6 being of grade I, 23 of grade II, 4 of grade III and 1 of grade IV according to Hunt-Hess grading, were analyzed retrospectively. Fourteen patients were treated within 3 days, and 20 patients were treated in the 4th to 6th days after the rupture. Two cases of wide-neck aneurysm were embolized with Medtronic AVE stent supported GDC. Angiography was used to observe the effects.
Results:
Angiography showed complete occlusion in 28 cases and 90% occlusion in 4 cases. One aneurysm was ruptured during the procedure. The caudal tip of GDC protruded to the parent vessel in 2 cases. Two cases failed to be embolized due to severe cerebrovascular spasm. There were no mortality and complications. No re-rupture occurred in the follow-up.
Conclusion:
Less invasive and with less risk and complication, early GDC embolization is one of the ideal therapeutic methods to manage acute ruptured aneurysms.
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