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Haemodynamic consequences of embolizing aneurysms: a transcranial Doppler study
J G Rowe1, J V Byrne, A Molyneux
1MRC Magnetic Resonance Spectroscopy Unit, John Radcliffe Hospital, Headington, Oxford, UK.
British Journal of Neurosurgery
|January 1, 1995
Summary
Endovascular treatment using Guglielmi detachable coils for brain aneurysms showed hemodynamic stability. This study suggests coil embolization is a safe method for treating ruptured aneurysms without causing vasospasm.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Medical Imaging
Background:
- Cerebral aneurysms pose a significant risk of rupture and hemorrhage.
- Endovascular coiling is a common treatment for aneurysms.
- Understanding the hemodynamic effects of coiling is crucial for patient safety.
Purpose of the Study:
- To assess the hemodynamic changes during and after endovascular treatment of aneurysms using Guglielmi detachable coils.
- To evaluate the safety of coil embolization in terms of vasospasm and velocity changes.
Main Methods:
- Transcranial Doppler (TCD) was used to measure middle cerebral artery (MCA) velocities and pulsatility indices (PI) in 20 patients.
- Measurements were taken before, during, and after endovascular coiling procedures.
Main Results:
- Catheterization of the anterior circulation led to a 15-20% decrease in MCA velocities.
- Coil insertion into aneurysms caused a modest increase in PI, indicating cerebral circulation stiffening.
- No significant difference was observed in pre- and post-treatment velocities; no coil embolization-induced vasospasm was detected.
Conclusions:
- Endovascular treatment with Guglielmi detachable coils demonstrates hemodynamic stability during and after the procedure.
- Coil embolization appears to be a safe alternative for treating acutely ruptured aneurysms.
- The technique does not seem to precipitate vasospasm, supporting its clinical utility.