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GDC-system embolization for brain aneurysms - location and follow-up
B Richling1, A Gruber, G Bavinzski
1Department of Neurosurgery, University of Vienna Medical School, Austria.
Acta Neurochirurgica
|January 1, 1995
Summary
Guglielmi detachable coil (GDC) embolization offers low morbidity and mortality for brain aneurysms. It shows better stability for posterior circulation aneurysms, making it a valuable treatment option.
Area of Science:
- Neurosurgery
- Interventional Neuroradiology
- Cerebrovascular Disease
Background:
- Guglielmi detachable coil (GDC) embolization, introduced in 1991, is a key treatment for cerebral aneurysms worldwide.
- While GDC embolization boasts low morbidity and mortality, challenges remain in achieving complete neck occlusion, particularly for large-necked aneurysms.
- Recanalization rates vary based on coil architecture and distribution, though rebleeding rates remain low.
Purpose of the Study:
- To evaluate the efficacy and stability of GDC embolization for treating brain aneurysms.
- To analyze treatment outcomes based on aneurysm location and size.
- To compare the effectiveness of GDC embolization in anterior versus posterior circulation aneurysms.
Main Methods:
- Retrospective analysis of 74 GDC embolizations performed between March 1992 and June 1994, out of 211 treated brain aneurysms.
- Follow-up angiography was conducted on 55% of patients (41) at 6, 12, and 24 months, with a mean follow-up of 8 months.
- Aneurysms were categorized by location and size for graphical analysis of occlusion stability.
Main Results:
- The highest occlusion stability was observed in basilar tip aneurysms, followed by posterior inferior cerebellar artery (PICA) origin, basilar trunk, and posterior cerebral artery (PCA) aneurysms.
- Lower stability was noted for posterior communicating (PCom) artery, middle cerebral artery (MCA), anterior communicating (Acom) artery, and internal carotid artery aneurysms.
- Aneurysms in the posterior circulation demonstrated generally superior results compared to those in the anterior circulation.
Conclusions:
- GDC embolization is particularly effective for posterior circulation aneurysms, especially considering the surgical complexities in the posterior fossa.
- The technique provides a valuable treatment option with favorable outcomes, despite limitations in neck occlusion for certain aneurysm types.
- Long-term stability varies by aneurysm location, highlighting the importance of tailored treatment strategies.