- Detachable coils are placed into aneurysm lumen through a catheter which is inserted into an artery in the groin.
- Less invasive than neurosurgery with a more rapid recovery period.
- Follow up angiograms are performed to ensure against aneurysm recurrence.
Treatment of cerebral aneurysms using catheters inserted in the groin rather than brain surgery was pioneered in the 1970s by Dr. Serbinenko who placed small inflatable balloons inside aneurysms to isolate them from the parent blood vessel. Since then the focus of catheter therapy has shifted to embolization with retrievable platinum coils. The Guglielmi detachable coil (GDC) was developed in 1989 as an endovascular approach to cerebral aneurysm therapy. This technology was approved by the United States Food and Drug Administration in 1995 and has been increasingly utilized worldwide for treating cerebral aneurysms.
The objective of GDC therapy is to place a small plastic tube called a catheter into the femoral artery in the groin and use x-ray guidance to carefully navigate the catheter into the center lumen of the aneurysm. The retrievable platinum coils are then deployed through the catheter and placed into the center of the aneurysm. The GDC is a platinum coil that is fused to a stainless steel pusher wire. Following satisfactory placement of the coil in the aneurysm, the fused detachment zone is separated by a small electrical current (2-4 volts, 1 milliamp), thus separating the coil from the pusher wire and placing the coil permanently within the aneurysm. These platinum coils are relatively soft, adapting to the shape of the aneurysm, and are available in a variety of diameters, lengths, wire gauges, and softness. Additional coils are added until the aneurysm is maximally filled with platinum coils.
The primary advantage of endovascular GDC therapy of intracranial aneurysms is that it is less invasive than surgical clipping resulting in a more rapid recovery period. The size and configuration of the aneurysm are key factors with regard to the success of GDC therapy. Complete elimination of the aneurysm can be achieved approximately 70% of the time for aneurysms with a neck diameter less than 4mm. Although the long-term efficacy of GDC therapy remains to be determined, the incidence of aneurysm recurrence following GDC therapy has been estimated to be approximately 15%.
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