Coil Embolization of Intracranial Aneurysms

Abstract SINCE THE INTRODUCTION of Guglielmi detachable coils more than a decade ago, the coiling technique for the treatment of intracranial aneurysms has been enhanced with technical and technological refinements. Both neurosurgeons and neuroradiologists have participated in this process. Stents and nondetachable balloons have been useful in the coiling of some wide-necked aneurysms. An increasing number of neurosurgeons are pursuing fellowship training in neuroendovascular techniques. Moreover, most neurosurgeons work closely with neurointerventionists. In this communication, technical preferences developed during our experience with intracranial aneurysm coiling are summarized.

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Coil Migration under Stent-Assisted Embolization

Interventional Neuroradiology ◽

10.1177/159101990601200113 ◽

2006 ◽

Vol 12 (1) ◽

pp. 65-68 ◽

Cited By ~ 3

Author(s):

C.S. Cho

Keyword(s):

Intracranial Aneurysm ◽

Coil Embolization ◽

Intracranial Aneurysms ◽

Effective Treatment Option ◽

Parent Vessel ◽

Complex Aneurysms ◽

Delayed Complication ◽

Detachable Coils ◽

Neuroform Stent ◽

Coil Migration

Detachable coils are established as a safe and effective treatment option for some patients with intracranial aneurysms. However this treatment is not useful for the treatment of certain types of complicated aneurysms. Wide-necked or broad-based aneurysms are still complicated to embolize because of the risk of coil migration or coil protrusion into the parent vessel. The Neuroform stent has recently been introduced for the treatment of complex aneurysms. The stent functions primarily to provide durable parent vessel protection during embolization. This report demonstrates coil migration occurring as a delayed complication of Neuroform stent-assisedt coil embolization of a small intracranial aneurysm.

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Intracranial aneurysms treated with Guglielmi detachable coils: long-term imaging follow-up with contrast-enhanced magnetic resonance angiography

Yearbook of Diagnostic Radiology ◽

10.1016/s0098-1672(08)79046-5 ◽

2008 ◽

Vol 2008 ◽

pp. 273-274

Author(s):

A.G. Osborn

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Intracranial Aneurysms ◽

Guglielmi Detachable Coils ◽

Contrast Enhanced ◽

Detachable Coils

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Topic review: surface modifications enhancing biological activity of guglielmi detachable coils in treating intracranial aneurysms

Surgical Neurology ◽

10.1016/s0090-3019(00)00269-x ◽

2000 ◽

Vol 54 (1) ◽

pp. 34-41 ◽

Cited By ~ 27

Author(s):

John M Abrahams ◽

Scott L Diamond ◽

Robert W Hurst ◽

Eric L Zager ◽

M.Sean Grady

Keyword(s):

Biological Activity ◽

Intracranial Aneurysms ◽

Surface Modifications ◽

Guglielmi Detachable Coils ◽

Detachable Coils

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Late Thromboembolic Events after Treatment of Intracranial Aneurysms with Guglielmi Detachable Coils

Stroke ◽

10.1161/str.32.suppl_1.356-e ◽

2001 ◽

Vol 32 (suppl_1) ◽

pp. 356-357

Author(s):

Colin P Derdeyn ◽

Christopher J Moran ◽

DeWitte T Cross ◽

Michael R Chicoine ◽

Ralph G Dacey

Keyword(s):

Endovascular Treatment ◽

Intracranial Aneurysms ◽

Artery Aneurysm ◽

Additional Patient ◽

Superior Cerebellar Artery ◽

Parent Artery ◽

Imaging Data ◽

Guglielmi Detachable Coils ◽

Kaplan Meier ◽

Detachable Coils

P98 Purpose: Thrombo-embolic complications associated with the endovascular treatment of intracranial aneurysms with Guglielmi Detachable Coils (GDC) generally occur at the time of the procedure or soon after. The purpose of this report is to determine the frequency of late thrombo-embolic events after GDC. Methods: The records of 189 patients who underwent GDC repair of one or more intracranial aneurysms at our institution were reviewed. The occurence of an ischemic event referrable to a coiled aneurysm was determined by clinical, angiographic, and imaging data. Events occuring within 2 days of the endovascular procedure were considered peri-procedural. Kaplan-Meier analysis of ischemic events over time was performed. Results: Two patients suffered documented thrombo-embolic events. One patient presented 5 weeks after coiling with a transient ischemic attack. Angiography demonstrated thrombus on the surface of the coils at the neck of a large ophthalmic artery aneurysm. The second patient presented with a posterior circulation stroke 4 weeks after coiling of a large superior cerebellar artery aneurysm. Angiography showed no significant proximal disease, with thrombus beginning at the neck of the treated aneurysm and extending out both P1 segments. No intra-procedural problems during the initial coiling had occured with either patient. There was no evidence for protrusion of coils into the parent artery in either patient. Both patients had been receiving daily aspirin (325 mg). One additional patient reporting symptoms suggesting possible ischemics event was evaluated and diagnosed as having atypical migraines. The frequency of a clinical thromboembolic event during the first year after coiling (excluding procedural complications) was 1.1%. Conclusions: Thrombo-embolic events may occur as late as 5 weeks after endovascular treatment of aneurysms with GDC.

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LVIS Jr ‘shelf’ technique: an alternative to Y stent-assisted aneurysm coiling

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2015-012246 ◽

2016 ◽

Vol 8 (12) ◽

pp. 1256-1259 ◽

Cited By ~ 13

Author(s):

Elizabeth Hai Yen Du ◽

Jai Jai Shiva Shankar

Keyword(s):

High Risk ◽

Coil Embolization ◽

Intracranial Aneurysms ◽

Case Series ◽

Cell Design ◽

Short Term ◽

Aneurysm Neck ◽

Closed Cell ◽

Double Stent ◽

Aneurysm Coiling

Wide-necked bifurcation intracranial aneurysms have traditionally not been amenable to coil embolization with the use of a single stent due to the high risk of coil prolapse. Y-configuration double stent-assisted coil embolization (‘Y-stenting’) of this aneurysm type has been shown to have generally good clinical outcomes, although the technique is complex with various challenges described in the literature. The compliant and flexible closed-cell design of braided stents such as the LVIS Jr allows for the creation of a ‘shelf’ across the aneurysm neck sufficient to prevent coil prolapse. We describe this novel ‘shelf’ technique and present a small case series of LVIS Jr stent-assisted wide-necked bifurcation intracranial aneurysm coiling in eight patients. Our small, albeit important, case series demonstrates that the ‘shelf’ technique is feasible and safe with very good short-term clinical and angiographic outcomes, and may obviate the need for Y-stenting.

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