Electrothrombosis of saccular aneurysms via endovascular approach

Part 1: Electrochemical basis, technique, and experimental results

Restricted access

✓ 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.

Article Information

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.
Headings
References
  • 1.

    Abramson HA: A possible relationship between the current of injury and the white-blood cell in inflammation. Am J Med Sci 167:7027101924Abramson 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 CHanda HYoshida Ket 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 Medica1966 Vol 110 pp 651654Araki 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 FSDe Foyes JF: Cited by in Reference 25Bigelow 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 133:4474621951Blakemore 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 AHKing BG: Electrothermic coagulation of aortic aneurysms. JAMA 111:182118271938Blakemore 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 6:9141847Ciniselli L: Sulla elettro-puntura nella cura degli aneurismi. Gazz Med Ital Lomb Milano 6:9–14 1847

    • Search Google Scholar
    • Export Citation
  • 7.

    Cooper RCrow JH: Toxic effects of intra-cerebral electrodes. Med Biol Eng Comput 4:5755811966Cooper R Crow JH: Toxic effects of intra-cerebral electrodes. Med Biol Eng Comput 4:575–581 1966

    • Search Google Scholar
    • Export Citation
  • 8.

    Guglielmi GGuerrisi RGuidetti Bet 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 Neuroradiologia1983 pp 139146Guglielmi 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 GViñuela FDion Jet al: Electrothrombosis of saccular aneurysms via endovascular approach. Part 2: Preliminary clinical experience. J Neurosurg 75:8141991Guglielmi 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 2:76851975Hosobuchi 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 2:4855981951Linton RR: Intrasaccular wiring of abdominal arteriosclerotic aortic aneurysms by the “pack” method. Angiology 2:485–598 1951

    • Search Google Scholar
    • Export Citation
  • 12.

    Linton RRHardy IB Jr: Treatment of thoracic aortic aneurysms by the “pack” method of intrasaccular wiring. N Engl J Med 246:8478551952Linton 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 GEMcHardy JKelliher EMet al: Neural prosthesis in Williams DF (ed): Biocompatibility in Clinical Practice. Boca Raton, Fla: CRC Press1982 pp 123150Loeb 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 MDJohnsrude ISLimberakis AJet al: Clinical use of transcatheter electrocoagulation. Radiology 129:2112141978Miller MD Johnsrude IS Limberakis AJ et al: Clinical use of transcatheter electrocoagulation. Radiology 129:211–214 1978

    • Search Google Scholar
    • Export Citation
  • 15.

    Moore CHMurchison 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 4:3273351864Moore 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 41:6576701974Mullan 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 SBeckman FVailati Get al: An experimental approach to the problem of cerebral aneurysms. J Neurosurg 21:8388451964Mullan 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 SRaimondi AJDobben Get al: Electrically induced thrombosis in intracranial aneurysms. J Neurosurg 22:5395471965Mullan 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 SReyes CDawley Jet al: Stereotactic copper electric thrombosis of intracranial aneurysms. Prog Neurol Surg 3:1932111969Mullan 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 FABell WRMontali RJet al: Natural history of autologous blood clot embolization in swine. Invest Radiol 11:2672761976Osterman 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 & Co1832 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 JBillerey JConstant Pet al: Selective vascular thrombosis induced by a direct electrical current: animal experiments. J Neuroradiol 5:1391521978Piton 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 Press1956 pp 119 and 124–154Potter 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 9:135113561961Salazar 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 PNPate JW: Bio-electric phenomena as an etiologic factor in intravascular thrombosis. Am J Physiol 175:1031071953Sawyer 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 PNPate JW: Electric potential differences across the normal aorta and aortic grafts of dogs. Am J Physiol 175:1131171953Sawyer 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 PNPate JWWeldon CS: Relations of abnormal and injury electric potential differences to intravascular thrombosis. Am J Physiol 175:1081121953Sawyer 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 WMPizzo SVJackson DCet al: Transcatheter electrocoagulation: a therapeutic angiographic technique for vessel occlusion. Invest Radiol 12:1461531977Thompson 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 2:141831Velpeau 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 SCBlakemore AHKing BG: Aneurysm of the internal carotid artery within the skull: wiring and electrothermic coagulation. JAMA 116:5785821941Werner 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
TrendMD
Cited By
Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 518 515 88
Full Text Views 346 255 7
PDF Downloads 118 96 5
EPUB Downloads 0 0 0
PubMed
Google Scholar