Transarterial platinum coil occlusion of ruptured intracranial aneurysms: results in 51 patients.
Fifty-one patients with subarachnoid haemorrhage (SAH) due to ruptured intracranial aneurysm have been treated by the Guglielmi detachable platinum coil (GDC) treatment method; 36 patients within 28 days of the ictus. There was total body occlusion in 64.8%, subtotal body occlusion in 24.1% and failed coil placement in 11.1%. Technical success rates were highest in aneurysms with neck sizes up to 4 mm (75% total occlusion) and aneurysms smaller than 10 mm largest diameter (72.5% total occlusion). At discharge from primary care, there were 62.7% without deficit rising to 74.5% at follow-up assessment. Four patients are dead and one disabled (9.8%). Patient clinical outcomes relate most closely to Hunt and Hess grade at time of definitive treatment. Higher initial grades and poorer clinical outcomes are concentrated in patients treated in the first 14 days. The incidence of procedure related thrombo-embolic events has fallen from 20% in the first 30 patients to 4.8% in the next 21. Rebleeding during GDC procedures occurred in 20.6% of patients treated 1-14 days post SAH.
Apsimon
H T
HT
Interventional Neuroradiology Unit, Royal Perth Hospital, GPO Box X22213, Perth, Western Australia 6001, Australia.
Khangure
M S
MS
Knuckey
N
N
McAuliffe
W
W
Ives
F J
FJ