Electrothrombosis of saccular aneurysms via endovascular approach

Part 2: Preliminary clinical experience

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

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

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Jacques DionDepartment of Neurological Sciences, Therapeutic Neuroangiography, University of Rome Medical School, Rome, Italy; and Department of Radiological Sciences, Endovascular Therapy, University of California Medical Center, Los Angeles, California

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Gary DuckwilerDepartment of Neurological Sciences, Therapeutic Neuroangiography, University of Rome Medical School, Rome, Italy; and Department of Radiological Sciences, Endovascular Therapy, University of California Medical Center, Los Angeles, California

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✓ Fifteen patients with high-risk intracranial saccular aneurysms were treated using electrolytically detachable coils introduced via an endovascular approach. The patients ranged in age from 21 to 69 years. The most frequent clinical presentation was subarachnoid hemorrhage (eight cases). Considerable thrombosis of the aneurysm (70% to 100%) was achieved in all 15 patients, and preservation of the parent artery was obtained in 14. Although temporary neurological deterioration due to the technique was recorded in one patient, no permanent neurological deficit was observed in this series and there were no deaths. It is believed that this new technology is a viable alternative in the management of patients with high-risk intracranial saccular aneurysms. It may also play an important role in the occlusion of aneurysms in the acute phase of subarachnoid hemorrhage.

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  • 1.

    Guglielmi G, , Viñuela F, & Sepetka I, et al: Electrothrombosis of saccular aneurysms via endovascular approach. Part 1: Electrochemical basis, technique, and experimental results. J Neurosurg 75:17, 1991 Guglielmi G, Viñuela F, Sepetka I, et al: Electrothrombosis of saccular aneurysms via endovascular approach. Part 1: Electrochemical basis, technique, and experimental results. J Neurosurg 75:1–7, 1991

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  • 2.

    Hieshima GB, , Higashida RT, & Wapenski J, et al: Balloon embolization of a large distal basilar artery aneurysm. Case report. J Neurosurg 65:413416, 1986 Hieshima GB, Higashida RT, Wapenski J, et al: Balloon embolization of a large distal basilar artery aneurysm. Case report. J Neurosurg 65:413–416, 1986

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  • 3.

    Higashida RT, , Halbach VV, & Barnwell SL, et al: Treatment of intracranial aneurysms with preservation of the parent vessel: results of percutaneous balloon embolization in 84 patients. AJNR 11:633640, 1990 Higashida RT, Halbach VV, Barnwell SL, et al: Treatment of intracranial aneurysms with preservation of the parent vessel: results of percutaneous balloon embolization in 84 patients. AJNR 11:633–640, 1990

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  • 4.

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    Kassell NF, , Torner JC, & Haley EC Jr, et al: The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: Overall management results. J Neurosurg 73:1836, 1990 Kassell NF, Torner JC, Haley EC Jr, et al: The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: Overall management results. J Neurosurg 73:18–36, 1990

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    Romodanov AP, & Shcheglov VI: Intravascular occlusion of saccular aneurysms of the cerebral arteries by means of a detachable balloon catheter. Adv Tech Stand Neurosurg 9:2548, 1982 Romodanov AP, Shcheglov VI: Intravascular occlusion of saccular aneurysms of the cerebral arteries by means of a detachable balloon catheter. Adv Tech Stand Neurosurg 9:25–48, 1982

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  • 9.

    Weir B: Intracranial aneurysms and subarachnoid hemorrhage: an overview, in Wilkins RH, & Rengachary SS (eds): Neurosurgery. New York: McGraw-Hill, 1984, Vol 2, pp 13081329 Weir B: Intracranial aneurysms and subarachnoid hemorrhage: an overview, in Wilkins RH, Rengachary SS (eds): Neurosurgery. New York: McGraw-Hill, 1984, Vol 2, pp 1308–1329

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