Electrothrombosis of saccular aneurysms via endovascular approach

Part 1: Electrochemical basis, technique, and experimental results

Guido GuglielmiDepartment of Neurological Sciences, Therapeutic Neuroangiography, University of Rome Medical School, Rome, Italy; Department of Radiological Sciences, Endovascular Therapy, University of California Medical Center, Los Angeles, California; and Target Therapeutics, San Jose, California

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Fernando ViñuelaDepartment of Neurological Sciences, Therapeutic Neuroangiography, University of Rome Medical School, Rome, Italy; Department of Radiological Sciences, Endovascular Therapy, University of California Medical Center, Los Angeles, California; and Target Therapeutics, San Jose, California

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Ivan SepetkaDepartment of Neurological Sciences, Therapeutic Neuroangiography, University of Rome Medical School, Rome, Italy; Department of Radiological Sciences, Endovascular Therapy, University of California Medical Center, Los Angeles, California; and Target Therapeutics, San Jose, California

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Velio MacellariDepartment of Neurological Sciences, Therapeutic Neuroangiography, University of Rome Medical School, Rome, Italy; Department of Radiological Sciences, Endovascular Therapy, University of California Medical Center, Los Angeles, California; and Target Therapeutics, San Jose, California

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1–7
Volume/Issue:
Volume 75: Issue 1
DOI link:
https://doi.org/10.3171/jns.1991.75.1.0001
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✓ Eleven experimental saccular aneurysms were created on the common carotid artery of swine. Between 3 and 15 days after creation of these aneurysms, they were thrombosed via an endovascular approach, using a very soft detachable platinum coil delivered through a microcatheter positioned within the aneurysm. This detachable platinum coil was soldered to a stainless steel delivery guidewire. Intra-aneurysmal thrombosis was then initiated by applying a low positive direct electric current to the delivery guidewire. Thrombosis occurred because of the attraction of negatively charged white blood cells, red blood cells, platelets, and fibrinogen to the positively charged platinum coil positioned within the aneurysm. The passage of electric current detached the platinum coil within the clotted aneurysm in 4 to 12 minutes. This detachment was elicited by electrolysis of the stainless steel wire nearest to the thrombus-covered platinum coil. Control angiograms obtained 2 to 6 months postembolization confirmed permanent aneurysm occlusion as well as patency of the parent artery in all cases. No angiographic manifestation of untoward distal embolization was noted. Due to the encouraging results of this research, this technique has been applied in selected clinical cases which are described in Part 2 of this study.

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Contributor Notes

Address reprint requests to: Guido Guglielmi, M.D., Universita' di Roma, Dipartimento di Scienze Neurologiche, Neuroangiografia Terapeutica, Viale dell'Universita' 30/a, 00185 Roma, Italy.
  • 1.

    Abramson HA: A possible relationship between the current of injury and the white-blood cell in inflammation. Am J Med Sci 167:702–710, 1924 Abramson HA: A possible relationship between the current of injury and the white-blood cell in inflammation. Am J Med Sci 167:702–710, 1924

    • Search Google Scholar
    • Export Citation
  • 2.

    Araki C, , Handa H, & Yoshida K, et al: Electrically induced thrombosis for the treatment of intracranial aneurysms and angiomas, in deVet AC (ed): Proceedings of the Third International Congress of Neurological Surgery, Copenhagen 1965. Amsterdam: Excerpta Medica, 1966, Vol 110, pp 651–654 Araki C, Handa H, Yoshida K, et al: Electrically induced thrombosis for the treatment of intracranial aneurysms and angiomas, in deVet AC (ed): Proceedings of the Third International Congress of Neurological Surgery, Copenhagen 1965. Amsterdam: Excerpta Medica, 1966, Vol 110, pp 651–654

    • Search Google Scholar
    • Export Citation
  • 3.

    Bigelow FS, & De Foyes JF: Cited by in Reference 25 Bigelow FS, De Foyes JF: Cited by in Reference 25

  • 4.

    Blakemore AH: Progressive constrictive occlusion of the abdominal aorta with wiring and electrothermic coagulation: one-stage operation for arteriosclerotic aneurysms of the abdominal aorta. Am Surg 133:447–462, 1951 Blakemore AH: Progressive constrictive occlusion of the abdominal aorta with wiring and electrothermic coagulation: one-stage operation for arteriosclerotic aneurysms of the abdominal aorta. Am Surg 133:447–462, 1951

    • Search Google Scholar
    • Export Citation
  • 5.

    Blakemore AH, & King BG: Electrothermic coagulation of aortic aneurysms. JAMA 111:1821–1827, 1938 Blakemore AH, King BG: Electrothermic coagulation of aortic aneurysms. JAMA 111:1821–1827, 1938

    • Search Google Scholar
    • Export Citation
  • 6.

    Ciniselli L: Sulla elettro-puntura nella cura degli aneurismi. Gazz Med Ital Lomb Milano 6:9–14, 1847 Ciniselli L: Sulla elettro-puntura nella cura degli aneurismi. Gazz Med Ital Lomb Milano 6:9–14, 1847

    • Search Google Scholar
    • Export Citation
  • 7.

    Cooper R, & Crow JH: Toxic effects of intra-cerebral electrodes. Med Biol Eng Comput 4:575–581, 1966 Cooper R, Crow JH: Toxic effects of intra-cerebral electrodes. Med Biol Eng Comput 4:575–581, 1966

    • Search Google Scholar
    • Export Citation
  • 8.

    Guglielmi G, , Guerrisi R, & Guidetti B, et al: L'elettrotrombosi intravasale nelle malformazioni vascolari sperimentalmente provocate, in Carella A (ed): Proceedings of III Congress of the Italian Society of Neuroradiology. Bari: Associazione Italiana di Neuroradiologia, 1983, pp 139–146 Guglielmi G, Guerrisi R, Guidetti B, et al: L'elettrotrombosi intravasale nelle malformazioni vascolari sperimentalmente provocate, in Carella A (ed): Proceedings of III Congress of the Italian Society of Neuroradiology. Bari: Associazione Italiana di Neuroradiologia, 1983, pp 139–146

    • Search Google Scholar
    • Export Citation
  • 9.

    Guglielmi G, , Viñuela F, & Dion J, et al: Electrothrombosis of saccular aneurysms via endovascular approach. Part 2: Preliminary clinical experience. J Neurosurg 75:8–14, 1991 Guglielmi G, Viñuela F, Dion J, et al: Electrothrombosis of saccular aneurysms via endovascular approach. Part 2: Preliminary clinical experience. J Neurosurg 75:8–14, 1991

    • Search Google Scholar
    • Export Citation
  • 10.

    Hosobuchi Y: Electrothrombosis of carotid-cavernous fistula. J Neurosurg 2:76–85, 1975 Hosobuchi Y: Electrothrombosis of carotid-cavernous fistula. J Neurosurg 2:76–85, 1975

    • Search Google Scholar
    • Export Citation
  • 11.

    Linton RR: Intrasaccular wiring of abdominal arteriosclerotic aortic aneurysms by the “pack” method. Angiology 2:485–598, 1951 Linton RR: Intrasaccular wiring of abdominal arteriosclerotic aortic aneurysms by the “pack” method. Angiology 2:485–598, 1951

    • Search Google Scholar
    • Export Citation
  • 12.

    Linton RR, & Hardy IB Jr: Treatment of thoracic aortic aneurysms by the “pack” method of intrasaccular wiring. N Engl J Med 246:847–855, 1952 Linton RR, Hardy IB Jr: Treatment of thoracic aortic aneurysms by the “pack” method of intrasaccular wiring. N Engl J Med 246:847–855, 1952

    • Search Google Scholar
    • Export Citation
  • 13.

    Loeb GE, , McHardy J, & Kelliher EM, et al: Neural prosthesis, in Williams DF (ed): Biocompatibility in Clinical Practice. Boca Raton, Fla: CRC Press, 1982, pp 123–150 Loeb GE, McHardy J, Kelliher EM, et al: Neural prosthesis, in Williams DF (ed): Biocompatibility in Clinical Practice. Boca Raton, Fla: CRC Press, 1982, pp 123–150

    • Search Google Scholar
    • Export Citation
  • 14.

    Miller MD, , Johnsrude IS, & Limberakis AJ, et al: Clinical use of transcatheter electrocoagulation. Radiology 129:211–214, 1978 Miller MD, Johnsrude IS, Limberakis AJ, et al: Clinical use of transcatheter electrocoagulation. Radiology 129:211–214, 1978

    • Search Google Scholar
    • Export Citation
  • 15.

    Moore CH, & Murchison C: On a new method of procuring the consolidation of fibrin in certain incurable aneurisms: with the report of a case in which an aneurism of the ascending aorta was treated by the insertion of wire. Proc R Med Chir Soc Lond 4:327–335, 1864 Moore CH, Murchison C: On a new method of procuring the consolidation of fibrin in certain incurable aneurisms: with the report of a case in which an aneurism of the ascending aorta was treated by the insertion of wire. Proc R Med Chir Soc Lond 4:327–335, 1864

    • Search Google Scholar
    • Export Citation
  • 16.

    Mullan S: Experiences with surgical thrombosis of intracranial berry aneurysms and carotid cavernous fistulas. J Neurosurg 41:657–670, 1974 Mullan S: Experiences with surgical thrombosis of intracranial berry aneurysms and carotid cavernous fistulas. J Neurosurg 41:657–670, 1974

    • Search Google Scholar
    • Export Citation
  • 17.

    Mullan S, , Beckman F, & Vailati G, et al: An experimental approach to the problem of cerebral aneurysms. J Neurosurg 21:838–845, 1964 Mullan S, Beckman F, Vailati G, et al: An experimental approach to the problem of cerebral aneurysms. J Neurosurg 21:838–845, 1964

    • Search Google Scholar
    • Export Citation
  • 18.

    Mullan S, , Raimondi AJ, & Dobben G, et al: Electrically induced thrombosis in intracranial aneurysms. J Neurosurg 22:539–547, 1965 Mullan S, Raimondi AJ, Dobben G, et al: Electrically induced thrombosis in intracranial aneurysms. J Neurosurg 22:539–547, 1965

    • Search Google Scholar
    • Export Citation
  • 19.

    Mullan S, , Reyes C, & Dawley J, et al: Stereotactic copper electric thrombosis of intracranial aneurysms. Prog Neurol Surg 3:193–211, 1969 Mullan S, Reyes C, Dawley J, et al: Stereotactic copper electric thrombosis of intracranial aneurysms. Prog Neurol Surg 3:193–211, 1969

    • Search Google Scholar
    • Export Citation
  • 20.

    Osterman FA, , Bell WR, & Montali RJ, et al: Natural history of autologous blood clot embolization in swine. Invest Radiol 11:267–276, 1976 Osterman FA, Bell WR, Montali RJ, et al: Natural history of autologous blood clot embolization in swine. Invest Radiol 11:267–276, 1976

    • Search Google Scholar
    • Export Citation
  • 21.

    Phillips B: A series of experiments performed for the purpose of showing that arteries may be obliterated without ligature, compression, or the knife. London: Longman & Co, 1832, p 66 (Pamphlet) Phillips B: A series of experiments performed for the purpose of showing that arteries may be obliterated without ligature, compression, or the knife. London: Longman & Co, 1832, p 66 (Pamphlet)

    • Search Google Scholar
    • Export Citation
  • 22.

    Piton J, , Billerey J, & Constant P, et al: Selective vascular thrombosis induced by a direct electrical current: animal experiments. J Neuroradiol 5:139–152, 1978 Piton J, Billerey J, Constant P, et al: Selective vascular thrombosis induced by a direct electrical current: animal experiments. J Neuroradiol 5:139–152, 1978

    • Search Google Scholar
    • Export Citation
  • 23.

    Potter EC: Electrochemistry, Principles and Applications. London: Cleaver-Hume Press, 1956, pp 1–19 and 124–154 Potter EC: Electrochemistry, Principles and Applications. London: Cleaver-Hume Press, 1956, pp 1–19 and 124–154

    • Search Google Scholar
    • Export Citation
  • 24.

    Salazar AE: Experimental myocardial infarction. Induction of coronary thrombosis in the intact closed chest dog. Circ Res 9:1351–1356, 1961 Salazar AE: Experimental myocardial infarction. Induction of coronary thrombosis in the intact closed chest dog. Circ Res 9:1351–1356, 1961

    • Search Google Scholar
    • Export Citation
  • 25.

    Sawyer PN, & Pate JW: Bio-electric phenomena as an etiologic factor in intravascular thrombosis. Am J Physiol 175:103–107, 1953 Sawyer PN, Pate JW: Bio-electric phenomena as an etiologic factor in intravascular thrombosis. Am J Physiol 175:103–107, 1953

    • Search Google Scholar
    • Export Citation
  • 26.

    Sawyer PN, & Pate JW: Electric potential differences across the normal aorta and aortic grafts of dogs. Am J Physiol 175:113–117, 1953 Sawyer PN, Pate JW: Electric potential differences across the normal aorta and aortic grafts of dogs. Am J Physiol 175:113–117, 1953

    • Search Google Scholar
    • Export Citation
  • 27.

    Sawyer PN, , Pate JW, & Weldon CS: Relations of abnormal and injury electric potential differences to intravascular thrombosis. Am J Physiol 175:108–112, 1953 Sawyer PN, Pate JW, Weldon CS: Relations of abnormal and injury electric potential differences to intravascular thrombosis. Am J Physiol 175:108–112, 1953

    • Search Google Scholar
    • Export Citation
  • 28.

    Thompson WM, , Pizzo SV, & Jackson DC, et al: Transcatheter electrocoagulation: a therapeutic angiographic technique for vessel occlusion. Invest Radiol 12:146–153, 1977 Thompson WM, Pizzo SV, Jackson DC, et al: Transcatheter electrocoagulation: a therapeutic angiographic technique for vessel occlusion. Invest Radiol 12:146–153, 1977

    • Search Google Scholar
    • Export Citation
  • 29.

    Velpeau A: Mémoire sur la piqûre ou l'acupunture des artères dans le traitement des anévrismes. Gaz Med Paris 2:1–4, 1831 Velpeau A: Mémoire sur la piqûre ou l'acupunture des artères dans le traitement des anévrismes. Gaz Med Paris 2:1–4, 1831

    • Search Google Scholar
    • Export Citation
  • 30.

    Werner SC, , Blakemore AH, & King BG: Aneurysm of the internal carotid artery within the skull: wiring and electrothermic coagulation. JAMA 116:578–582, 1941 Werner SC, Blakemore AH, King BG: Aneurysm of the internal carotid artery within the skull: wiring and electrothermic coagulation. JAMA 116:578–582, 1941

    • Search Google Scholar
    • Export Citation

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