Thromboembolic Events Associated with Coil Protrusion into Parent Arteries after GDC Treatment

摘要: Aneurysm embolization using Guglielmi detachable coils(GDC) is gaining acceptance as a viable alternative to surgery in the treatment of cerebral aneurysms. During GDC aneurysms, thromboembolic events are most frequent complications. As risk factors events, large wide-necked use balloon-assisted technique and protruding coils into parent arteries previously reported. From March, 1997 till August, 2004, 270 consecutive patients were treated with at our institute. Fourteen (5.2%) 14 aneurysms these presented vessels. Twelve small (diameter 4 mm). The fundus-to-neck ratio ranged from 1.04 2.78, an average 1.53. In this series, ten (71%) balloon-remodelling because every patient had either aneurysm or complicated morphologic factors. These divided two groups according mode coil protrusion, loop type tail protrusion. first was protruded five (36%) cases patients, four last seven (50%), Five Diffusion-weighted imaging abnormalities found for (50%) within 24 hours coiling procedures. Three (21%) showed lesions ( 5 mm) detected. Symptomatic complications occurred (29%) all One who infarctions experienced minimal deficits (slight motor weakness, quadrantic hemianopsia) after six days postprocedure fully recovered by discharge stronger systemic heparinization (24000U, three days), aspirin (100 mg/day) Ticlopidine mg/day). territorial moderate deficits. Two one Argatroban (60 mg/day, following Finally, patiens discharged permanent (hypoesthesia only) hemiparesis. related procedures more common sequelae protrusions, especially Although neurological rare, high rate associated protrusion suggest that aggressive medical should be considered.