[Intracranial aneurysms treated by means Guglielmi detachable coil].

AIM

The endovascular treatment of an intracranial aneurysm using the Guglielmi detachable coil (GDC) becomes more and more treatment of choice which is based on aneurysm configuration, aneurysm location, the patient's medical and neurological condition and age, available surgical and interventional abilities at the treatmant center, and patient preference.

METHODS

Out of 73 patients with the intracranial aneurysm, 9 were treated by the endosaccular embolization using the Guglielmi detachable coil. Subarachnoid hemorrhage (SAH) occured in 8 patients and a spacio-compressive effect caused epilepsy in one patient. Three patients with multiple aneurysms were treated by the combination of microsurgical clipping and endosaccular embolization. The outcome was obtained after 6-12 months on the basis of Glasgow outcome scale.

RESULTS

Out of five patients treated in acute phase of severe subarachnoid hemorrhage (Hunt-Hess grade 4 and 5), one patient died for an inicial hemorrhage, one had a severe disability, and three patients had a good recovery or moderate disability. Two patients with the multiple aneurysms returned to the same quality of life as before the SAH, and one patient had moderate disability.

CONCLUSION

Microsurgical clipping of the neck of aneurysm is an optimal way of treatment for the most of ruptured intracranial aneurysms. Endosaccular embolization becomes more and more the treatment of choice in selected cases.