Assessment of acutely unsuccessful attempts at detachable coiling in intracranial aneurysms
Abstract
Guglielmi detachable coiling (GDC) has quickly become the most common endovascular method for the treatment of intracranial aneurysms. Although several published case series describe various authors' successful experiences or complications, few have elaborated on failed attempts. We examined our experience with GDC, and we analyzed all failed attempts at coiling. Patients who underwent endovascular procedures from September 1995 through July 1999 were identified using endovascular case logs and billing records. Patient charts were then reviewed retrospectively for failed attempts at GDC. A treatment failure was defined as an inability to place coils into an aneurysm, a GDC procedure-related complication resulting in death, or an acute rehemorrhage from a coiled aneurysm that indicated a failure of coils to prevent rerupture. Thromboembolic events and other nonfatal sources of morbidity that did not preclude coiling of the aneurysm were analyzed only to the extent that they prevented successful coiling of the aneurysm. From September 1995 to June 1999, 241 patients underwent GDC embolizations or attempts. In these patients, 35 procedures were unsuccessful, including 7 deaths from intraoperative or postoperative aneurysmal rerupt...Continue Reading
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