Haemodynamic consequences of embolizing aneurysms: a transcranial Doppler study

Twenty patients with aneurysms were studied with transcranial Doppler before, during and after endovascular treatment with Guglielmi detachable coils. Catheterization of the anterior circulation decreased middle cerebral artery velocities by 15-20%. Inserting coils into the aneurysms increased pulsatility indices modestly, reflecting a stiffening of the cerebral circulation. Pre- and posttreatment velocities were not significantly different, and there was no evidence of coil embolization precipitating vasospasm. The haemodynamic stability, seen during and after therapy, suggests that coil embolization may prove a safe alternative way of treating acutely ruptured aneurysms.