Embolization of intracranial aneurysm by Guglielmi detachable coils in 93 patients

Objective: To retrospectively study embolization by Guglielmi detachable coil (GDCs) in 93 patients with 118 intracranial aneurysms and to access its indication, technical tip, prevention and treatment of complications. Methods: From July 1998 to February 2000, 93 patients with intracranial aneurysms (Hunt Hess grade, Ⅰ18 cases, Ⅱ 29 cases, Ⅲ 25 cases, Ⅳ 10 cases, Ⅴ 2 cases)were embolized using GDCs, including 84 ruptured aneurysms. Eighty patients were treated with emergency. Continuous lumbar subarachnoid drainage was instituted and standard three H treatment was given postopertively. Results: Total occlusion was achieved in 104 aneurysms(88.14%), over 90% in 11 aneurysms(9.32%), less than 90% in 3 aneurysms (2.54%), with 3 patients (3/93, 3.23%) died in the cohort.One case rebleeded after one and a half months and was cured by surgical clipping, 2 patients experienced enlargement of the aneurysmal neck and were reembolized. One had severe disability, 7 had mild neurological deficit. Conclusion: Embolization of intracranial aneurysms with GDCs is safe, effective and reliable.Partial packing may result in continuous enlargement, rupture and bleeding, while tight coil packing is reliable. The ruptured aneurysms need emergent embolization and continuous lumbar subarachnoid drainage postoperatively can enhance curative effect significantly. [