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Updated: Jun 11, 2026
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Published on: May 6, 2020
Angiographic Follow-up of Embolization Using Guglielmi Detachable Coils for Cerebral Aneurysms
1Department of Neurosurgery, Mito National Hospital; Higashihara, Mito, Ibaraki; Japan - y-nakai@fg7.so-net.ne.jp.
Insights
Guglielmi Detachable Coils (GDC) show variable long-term stability for cerebral aneurysms. Ruptured aneurysms exhibit significant differences in stability compared to unruptured ones, necessitating close follow-up.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Vascular Neurology
Background:
- Cerebral aneurysms pose a significant risk of subarachnoid hemorrhage.
- Endovascular embolization using Guglielmi Detachable Coils (GDC) is a common treatment modality.
- Assessing the long-term angiographical stability of GDC is crucial for patient management.
Purpose of the Study:
- To evaluate the mid- to long-term angiographical stability of GDC after embolization of cerebral aneurysms.
- To compare the stability between ruptured and unruptured aneurysms treated with GDC.
Main Methods:
- Retrospective analysis of 164 cerebral aneurysms (116 ruptured, 48 unruptured) treated with GDC between March 1997 and November 2001.
- Follow-up cerebral angiograms obtained in 111 aneurysms (71 ruptured, 40 unruptured) at least one month post-embolization.
- Assessment of occlusion status, morphological changes, progressive thrombosis, and recanalization.
Main Results:
- Initial complete occlusion rates varied: 31/71 ruptured and 15/40 unruptured aneurysms.
- Morphological changes observed in 37% of ruptured and 30% of unruptured aneurysms during follow-up.
- Recanalization occurred in 14/71 ruptured aneurysms, while progressive thrombosis was noted in 12/71 ruptured and 12/40 unruptured aneurysms.
Conclusions:
- Significant differences exist in long-term angiographical stability between ruptured and unruptured cerebral aneurysms treated with GDC.
- Rigorous follow-up angiography is essential, particularly for ruptured aneurysms where complete occlusion is not initially achieved.
Summary:
The purpose of this study is to evaluate the mid or long-term angiographical stability of Guglielmi Detachable Coils (GDC) after embolization for cerebral aneurysms. Between march 1997 and november 2001, 164 aneurysms, including 116 ruptured and 48 unruptured aneurysms, were treated using GDC at Mito National Hospital. Cerebral angiograms over one month after embolization were obtained in 111 aneurysms, including 71 ruptured and 40 unruptured aneurysms.At the time of initial GDC embolization of the 71 ruptured aneurysms, complete occlusion was achieved in 31 aneurysms, neck remnant in 18 aneurysms, and body filling in 22 aneurysms. Morphological changes were observed in 26 aneurysms (37%) in follow-up. Progressive thrombosis was obtained in 12 out of 71 aneurysms, no changes were shown in 45, and recanalizations occurred in 14. In the initial embolization of the 40 unruptured aneurysms, complete occlusion was achieved in 15 aneurysms, neck remnant in five and body filling in 20 aneurysms respectively. Morphological changes were observed in 12 aneurysms (30%), in which 12 aneurysms showed progressive thrombosis and 28 aneurysms were unchanged. There were significant differences of the longterm angiographical stability between ruptured and unruptured aneurysms. Rigorous follow-up angiography is mandatory when complete aneurysm occlusion is not achieved in ruptured aneurysms.
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