Search

Guglielmi detachable coils (GDCs) provide an endovascular means for aneurysm treatment; however, their role has yet to be defined. This article reviews the most recent clinical series regarding efficacy, safety, and clinical outcomes in both the acute and nonacute setting. Successful treatment was possible in the majority of cases and included cases of complete aneurysm obliteration and with only a small neck remnant. Patients with a neck remnant often received additional treatments although some patients went on to complete obliteration without further treatment. Successful treatment provided protection from rebleeding in a follow-up period of 2 years. Success depended on operator experience as well as width of the aneurysm ostium. Recurrence and incomplete obliteration were more common with giant or large aneurysms and aneurysms with a wide base. Major procedurerelated complications predominantly resulted from intraprocedural rupture and thromboembolic events. These could both be treated via endovascular means at the time of the procedure. Thromboembolic events occurred more frequently with acutely ruptured aneurysms, especially aneurysms with a wide base. Vasospasm rates were not found to vary significantly from those found in surgical series when corrected for Fisher grouping. Morbidity and mortality rates as well as Glasgow outcome scores were at least as good as what would be expected from surgery during both the acute and nonacute setting. The papers reviewed indicate that the GDC provides safe and efficacious treatment for most berry aneurysms in both the acute and nonacute setting relative to surgical results. [ABSTRACT FROM AUTHOR]

Copyright of Neurologia (Grupo ARS XXI de Comunicacion, S.A.) is the property of Grupo ARS XXI de Comunicacion, S.A. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)