Mechanical detachment of Guglielmi detachable coils after failed electrolytic detachment: rescue from a technical complication.
OBJECTIVE
We describe the mechanical detachment of 2 Guglielmi detachable coils (GDC) that had been placed in a ruptured aneurysm and that failed to detach by electrolysis.


METHODS
Mechanical detachment was attempted by continuously rotating the delivery wire. The feasibility and reproducibility of this maneuver was tested by conducting additional in vitro tests.


RESULTS
Two GDCs that had been positioned in a ruptured cerebral aneurysm and had failed to detach by electrolysis were separated from the delivery wire by rotating the wire until the weakest segment of the coils broke. GDCs tested in vitro with correct detachment positioning could be separated from the microcatheter tip by approximately 15 rotations of the delivery wire without coil loop movement inside the aneurysm.


CONCLUSIONS
Mechanical detachment of an electrolytic GDC by rotating the delivery wire until a break occurs can be safely performed in a potentially risky situation caused by detachment failure during GDC embolization of cerebral aneurysms.
Lee
Chang-Young
CY
Department of Neurosurgery, Keimyung University School of Medicine, Daegu, Korea. nslcy@dsmc.or.kr
Yim
Man-Bin
MB
Benndorf
Goetz
G
D000368:Aged; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D004868:Equipment Failure; D005240:Feasibility Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008954:Models, Biological; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D012399:Rotation; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*