Prevention and management of the complications during embolizing intracranial aneurysm with GDC

Objective To sum up the experience of embolization of intracranial aneurysm with Guglielmi detachable coil (GDC) and to discuss how to prevent and manage the complications during the endovascular treatment. Methods 108 patients with intracranial aneurysm were embolized with GDC. 24 accidents out of 20 patients during embolization were reviewed. Results Among the 24 accidents, there were 10 aneurysm rupture, 5 over embolization 5 coils end protrudings to parent artery, and 4 thrombosis. Once the aneurysm ruptures, neutralizing heparin and continuing embolization was administered. Among 10 cases of aneurysm ruptures, 4 were death, 1 was severe deformity, 1 was mild deformity. Thrombolysis, heparinization and raising blood pressure were used to control over embolization, coil protrusion, and thrombosis. Among 5 cases of over embolization, 1 died, 4 recovered. Among 5 cases of coils end protrudings, 1 was severe deformity, 1 was mild deformity . Among 4 cases of embolization, 1 died, 1 was led sensory aphasis. The accidents resulted in 5 deaths (4.6%), 4 permanent neurological deficits (3.7%). Conclusion The correct management of the complications during the treatment, the better understanding of the aneurysm and its parent artery angioanatomy and the improved skill of embolizing technique are helpful to reduce the accidents and increase the cure rate.