Guglielmi detachable coil treatment of XXXX : retrospective review of a 10-year single-center experience.

@entity1 @entity510 @entity235 @entity16 @entity439 @entity432 @entity204 @entity130 @entity1756
BACKGROUND AND PURPOSE: We retrospectively analyzed our results with Guglielmi detachable coils (GDCs) for the endovascular occlusion of acutely @entity1756 over 10 years. METHODS: Between 1991-2000, 83 @entity1 (mean age, 56.1 years) with @entity510 were treated with endovascular GDCs. @entity1 with @entity439 due to @entity130 or dissection and those with mycotic or fusiform @entity439 were excluded. Mean follow-up in survivors was 19.1 months, and the mean Hunt-Hess grade at admission was 2.2. Angiographic follow-up was performed in 93% of surviving @entity1 (mean interval, 11.6 months). The basilar caput (34 @entity1 ) and anterior communicating artery complex (19 @entity1 ) were most commonly treated. RESULTS: Sixty-four @entity1 (77%) had a Glasgow Outcome Scale score (GOS) of 4 or 5, nine (11%) had a score of 2 or 3, and 10 (12%) died. At follow-up, 24 @entity1 (35%) had complete @entity439 , 18 (26%) had a @entity235 -ear remnant, 24 (35%) had a residual neck, and two (3%) had residual @entity439 . No treated @entity439 rebled. Three @entity1 required surgical repair after incomplete endovascular treatment. Two or more @entity432 procedures were required in 28 @entity1 (34%). Major procedural complications occurred in two @entity1 (2%), resulting in serious @entity16 or @entity204 . CONCLUSION: Endovascular treatment of @entity1756 with GDCs has low morbidity, and it facilitates good overall outcomes in @entity1 after @entity510 . The short-term effectiveness of @entity432 in preventing aneurysmal rebleeding was excellent. Durability of the treatment in preventing long-term rebleeding as compared with direct surgical clipping warrants further study. Advances in device technology and technique may improve future outcomes.
