[The clinical value of three-dimensional computed tomographic angiography in embolization of acutely ruptured intracranial aneurysms with Guglielmi detachable coil].

OBJECTIVE

To evaluate the clinical value of three-dimensional computed tomographic angiography (3D-CTA) in embolization of ruptured intracranial aneurysms with Guglielmi detachable coil (GDC).

METHODS

From December 1998 to February 2002, 175 consecutive patients with acute subarachnoid hemorrhage (SAH) underwent 3D-CTA on the day of admission. All the patients with intracranial aneurysms diagnosed by 3D-CTA received emergency intraaneurysmal GDC embolization in case the ruptured aneurysm was suitable to endovascular therapy.

RESULTS

Eighty patients with intracranial aneurysms received successfully emergency GDC embolization according to the results of 3D-CTA, all verified by digital subtraction angiography (DSA). 3D-CTA was superior to DSA in depiction of the 3D anatomy of aneurysms and parent arteries and provided valuable information for embolization of intracranial aneurysms prior to catheter angiography, especially for anterior communicating artery aneurysms.

CONCLUSION

3D-CTA discloses the existence of intracranial aneurysms early, establishes the indications of embolization prior to the catheter angiography, determines the side of insertion of guiding catheters, helps choose the appropriate coil size, and may become a routine diagnostic modality.