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Adnan I. Qureshi, M. Fareed K. Suri, Jehanzeb Khan, Stanley H. Kim, Richard D. Fessler, Andrew J. Ringer, Lee R. Guterman and L. Nelson Hopkins

treat) morphological characteristics; GA = general anesthesia; PICA = posterior inferior cerebellar artery. Fig. 1. Bar graphs demonstrating lengths of postoperative ICU (upper) and hospital (lower) stays covering 91 admissions for 92 GDC embolization procedures performed to treat unruptured intracranial aneurysms while the patients were in awake states. Guglielmi detachable coil embolization was undertaken in awake patients during 58 procedures for 59 ruptured aneurysms. These aneurysms were located in the ICA in 10 patients, the MCA in

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A. Shahram Makoui, Donald A. Smith, Avery J. Evans and David W. Cahill

S ince Serbinenko 28 first described the treatment of cerebral aneurysms by using detachable balloons, tremendous progress has been made in endovascular therapy of cerebrovascular lesions. Guglielmi detachable coil technology reflects the current state-of-the-art endovascular treatment of cerebral aneurysms in the ongoing evolution of this field. Although GDC therapy is thought to afford protection from early repeated hemorrhage in the majority of ruptured aneurysms selected for treatment, 10, 20 the potential for aneurysm recurrence and recanalization is not

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Menno Sluzewski, Job A. Bosch, Willem Jan van Rooij, Peter C. G. Nijssen and Douwe Wijnalda

: Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: the preliminary University of Illinois at Chicago experience. Neurosurgery 43 : 1281 – 1297 , 1998 Debrun GM, Aletich VA, Kehrli P, et al: Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: the preliminary University of Illinois at Chicago experience. Neurosurgery 43: 1281–1297, 1998 6. Giannotta SL , Oppenheimer JH , Levy ML , et al : Management of intraoperative rupture of aneurysm without hypotension

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Colin P. Derdeyn, DeWitte T. Cross III, Christopher J. Moran, George W. Brown, Thomas K. Pilgram, Michael N. Diringer, Robert L. Grubb Jr., Keith M. Rich, Michael R. Chicoine and Ralph G. Dacey Jr.

of the human brain treated with Guglielmi detachable coils. J Neurosurg 91 : 284 – 293 , 1999 Bavinzski G, Talazoglu V, Killer M, et al: Gross and microscopic histopathological findings in aneurysms of the human brain treated with Guglielmi detachable coils. J Neurosurg 91: 284–293, 1999 3. Cognard C , Pierot L , Boulin A , et al : Intracranial aneurysms: endovascular treatment with mechanical detachable spirals in 60 aneurysms. Radiology 202 : 783 – 792 , 1997 Cognard C, Pierot L, Boulin A, et al

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Goro Otsuka, Shigeru Miyachi, Takashi Handa, Makoto Negoro, Takeshi Okamoto, Osamu Suzuki and Jun Yoshida

. Neurosurgery 36: 23–30, 1995 10. Lukin RR , Chambers AA , McLaurin R , et al : Thrombosed giant middle cerebral aneurysms. Neuroradiology 10 : 125 – 129 , 1975 Lukin RR, Chambers AA, McLaurin R, et al: Thrombosed giant middle cerebral aneurysms. Neuroradiology 10: 125–129, 1975 11. Malisch TW , Guglielmi G , Viñuela F , et al : Unruptured aneurysms presenting with mass effect symptoms: response to endosaccular treatment with Guglielmi detachable coils. Part I. Symptoms of cranial nerve

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Cameron G. McDougall, Van V. Halbach, Christopher F. Dowd, Randall T. Higashida, Donald W. Larsen and Grant B. Hieshima

T he management of intracranial aneurysms, particularly their endovascular management, continues to evolve. The use of electrolytically detachable platinum coils for the endovascular treatment of intracranial aneurysms was first described by Guglielmi and colleagues 10, 13 in 1991. Following that description, Guglielmi detachable coils (GDCs) were prospectively evaluated at selected North American medical centers to determine their utility in treating intracranial aneurysms that were not amenable to direct surgical therapy. The coils have also been used

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Gerhard Bavinzski, Volkan Talazoglu, Monika Killer, Bernd Richling, Andreas Gruber, Cordell E. Gross and Hanns Plenk Jr.

D espite the fact that increasing numbers of patients with cerebral aneurysms are being treated with Guglielmi detachable coils (GDCs), only seven reports are available that detail the histological responses induced by coils within human brain aneurysms. 3, 5, 6, 10, 12, 13 Over a period of 6 years, we have collected 18 specimens of human brain aneurysms that had been occluded with GDCs (17 were harvested at autopsy and one was removed at a subsequent surgery). The goals of the present study were: 1) to assess the extent of endothelialization at the parent

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Tim W. Malisch, Guido Guglielmi, Fernando Viñuela, Gary Duckwiler, Y. Pierre Gobin, Neil A. Martin, John G. Frazee and Joan S. Chmiel

E ndovascular treatment of intracranial aneurysms by using the Guglielmi detachable coil (GDC) is proving to be a safe method of preventing aneurysm rupture. 13–15, 24, 25, 39 Patients with unruptured intracranial aneurysms may present with symptoms related to the aneurysm's mass effect on either the brain parenchyma or cranial nerves. Previous reports have suggested that such symptoms can be affected by GDC embolization of the aneurysm. 11, 17, 18, 22, 24, 25, 38 This study was undertaken to evaluate the response of patients with cranial nerve deficits to

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Sten Solander, Alexandre Ulhoa, Fernando Viñuela, Gary R. Duckwiler, Y. Pierre Gobin, Neil A. Martin, John G. Frazee and Guido Guglielmi

surgery for asymptomatic, unruptured, intracranial aneurysms: a meta-analysis. J Neurosurg 81 : 837 – 842 , 1994 King JT Jr, Berlin JA, Flamm ES: Morbidity and mortality from elective surgery for asymptomatic, unruptured, intracranial aneurysms: a meta-analysis. J Neurosurg 81: 837–842, 1994 23. Malisch TW , Guglielmi G , Viñuela F , et al : Intracranial aneurysms treated with the Guglielmi detachable coil: midterm clinical results in a consecutive series of 100 patients. J Neurosurg 87 : 176 – 183 , 1997 Malisch TW, Guglielmi G, Viñuela F, et al

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Andrew A. Kanner, Shimon Maimon and Zvi H. Rappaport

al : The Guglielmi detachable coil in the treatment of arteriovenous fistulae. Intervent Neuroradiol 2 : 201 – 207 , 1996 Evans AJ, Jensen ME, Mathis MJ, et al: The Guglielmi detachable coil in the treatment of arteriovenous fistulae. Intervent Neuroradiol 2: 201–207, 1996 4. Forlodou P , de Kersaint-Gilly A , Pizzanelli J , et al : Ehlers-Danlos syndrome with a spontaneous caroticocavernous fistula occluded by detachable balloon: case report and review of the literature. Neuroradiology 38 : 595 – 597 , 1996 Forlodou P, de Kersaint-Gilly A