Meisel H J, Rodesch G, Alvarez H, Lasjaunias P, Brock M
Neurochirurgische Klinik, Universitätsklinikum Steglitz.
Zentralbl Neurochir. 1995;56(1):27-33.
The authors report on the endovascular occlusion of intracranial aneurysms with GDC coils in 8 patients. In 2 cases, the diagnosis was made because of subarachnoidal hemorrhage. Three patients complained about headache, and one patient had an oculomotor palsy. The findings were incidental in 2 cases. Angiography demonstrated an aneurysm of the internal carotid artery in 4 of the 6 females and in the 2 males (mean age 50 years) and a basilar artery aneurysm in 4 cases. The indication for endovascular treatment was established after carefully weighing the risks against those of a neurosurgical intervention. It was possible to occlude completely the aneurysm by induced electrothrombosis and to preserve the patency of the main vessel in all cases. One female (case 6) developed a hemiparesis due to embolism of a medial branch six hours after treatment. This receded completely after thrombolysis with urokinase. A second patient showed further growth of the internal carotid aneurysm on the control angiogram obtained after six months. Our initial results are encouraging. With increasing experience, endovascular treatment is expected to become the method of choice for the treatment of most inoperable cerebral aneurysms.