title: A multicenter study of 705 ruptured intracranial aneurysms treated with Guglielmi detachable coils.
abstract: OBJECTIVE
  The long-term durability of Guglielmi detachable coil (GDC) embolization of cerebral aneurysms is still unknown. The purpose of this study was to evaluate the stability of anatomic occlusion of aneurysms treated with GDCs and assess the rate of recanalization and re-treatment.
  
  
  METHODS
  A multicenter study involving 650 patients with 705 ruptured aneurysms treated with GDCs between January 1998 to May 2003 was conducted. During this period, 63% of ruptured aneurysms were treated by the endovascular technique. The morbidity and mortality associated with this technique, procedural feasibility, acute angiographic occlusion results, and long-term angiographic follow-up were assessed.
  
  
  RESULTS
  Overall technical feasibility of GDC treatment was 96.9%. Upon admission, 25% of patients were Hunt and Hess grade IV or V. Acute angiographic results in 683 aneurysms demonstrated total occlusion in 496 cases (72.6%), subtotal occlusion in 171 cases (25.%), and incomplete occlusion in 16 cases (2.4%). All patients were controlled by angiography and MR imaging at 3 months, 1 year, and subsequent yearly examinations post-treatment. A second treatment was performed in 27 cases (recanalization, 4.7%). Long-term follow-up angiograms (mean, 36 months) were obtained in 571 aneurysms (95%). Of them, 422 aneurysms (73.9%) demonstrated complete occlusion, 148 aneurysms (25.9%) demonstrated subtotal occlusion, and only 1 aneurysm was incompletely occluded. Overall mortality was 11.4% for all patients, with procedural mortality evaluated at 1.4%. Overall morbidity was calculated at 8.6%. Only one rebleeding occurred in our study, with a second procedure performed without vital consequences for the patient.
  
  
  CONCLUSIONS
  Our multicenter study confirms the stability of aneurysm embolization with GDC, with only 4.7% of aneurysms requiring re-treatment.
authors.affiliation: Department of Neuroradiology, University François Rabelais, Centre Hospitalier Universitaire Bretonneau, Tours, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Gallas
authors.forename: Anne
authors.initials: A
authors.lastname: Pasco
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Cottier
authors.forename: Jean
authors.initials: J
authors.lastname: Gabrillargues
authors.forename: Jacques
authors.initials: J
authors.lastname: Drouineau
authors.forename: Christophe
authors.initials: C
authors.lastname: Cognard
authors.forename: Denis
authors.initials: D
authors.lastname: Herbreteau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome