Journal article
Postprocedure ischemic events after treatment of intracranial aneurysms with Guglielmi detachable coils
Journal of neurosurgery, Vol.96(5), pp.837-843
2002
DOI: 10.3171/jns.2002.96.5.0837
PMID: 12008697
Abstract
Object: Ischemic stroke or transient ischemic attack (TIA) may occur after the treatment of intracranial aneurysms with Guglielmi detachable coils (GDCs). The purpose of the present study is to investigate possible risk factors for thromboembolic events and to determine their frequency and time course.
Methods: The records of 178 consecutive patients with 193 treated intracranial saccular aneurysms were reviewed. A total of 159 GDC procedures were performed to treat 143 aneurysms in 133 of those patients who were in good neurological condition, allowing clinical detection of postprocedure ischemic events (TIA or stroke). The association of clinical, anatomical, and pharmacological factors with intraprocedure intraarterial thrombus and with postprocedure ischemic events was investigated by using uni- and multivariate analyses. Thrombus protruding into the parent artery was noted during six of 159 GDC procedures, resulting in a clinical deficit in one patient. No factor was associated with intraprocedure intraarterial thrombus. Ten postprocedure ischemic events occurred in nine patients. Seven events occurred within 24 hours, and three events occurred between 24 hours and 58 days. Aneurysm diameter and protruding coils were significant independent predictors of postprocedure ischemic events in multivariate analysis (both p = 0.02). The actuarial risk of stroke was 3.8%.
Conclusions: Larger aneurysm diameter and protruding loops of coils are associated with postprocedure ischemic events after GDC placement. It is unlikely that GDC-treated aneurysms retain thromboembolic potential beyond 2 months.
Details
- Title: Subtitle
- Postprocedure ischemic events after treatment of intracranial aneurysms with Guglielmi detachable coils
- Creators
- Colin P DERDEYN - Interventional Neuroradiology Service, Neuroradiology Section; Mallinckrodt Institute of Radiology; and Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United StatesDewitte T CROSS - Interventional Neuroradiology Service, Neuroradiology Section; Mallinckrodt Institute of Radiology; and Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United StatesChristopher J MORAN - Interventional Neuroradiology Service, Neuroradiology Section; Mallinckrodt Institute of Radiology; and Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United StatesGeorge W BROWN - Interventional Neuroradiology Service, Neuroradiology Section; Mallinckrodt Institute of Radiology; and Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United StatesThomas K PILGRAM - Interventional Neuroradiology Service, Neuroradiology Section; Mallinckrodt Institute of Radiology; and Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United StatesMichael N DIRINGER - Interventional Neuroradiology Service, Neuroradiology Section; Mallinckrodt Institute of Radiology; and Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United StatesRobert L GRUBB - Interventional Neuroradiology Service, Neuroradiology Section; Mallinckrodt Institute of Radiology; and Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United StatesKeith M RICH - Interventional Neuroradiology Service, Neuroradiology Section; Mallinckrodt Institute of Radiology; and Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United StatesMichael R CHICOINE - Interventional Neuroradiology Service, Neuroradiology Section; Mallinckrodt Institute of Radiology; and Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United StatesRalph G DACEY - Interventional Neuroradiology Service, Neuroradiology Section; Mallinckrodt Institute of Radiology; and Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, United States
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.96(5), pp.837-843
- Publisher
- American Association of Neurological Surgeons; Park Ridge, IL
- DOI
- 10.3171/jns.2002.96.5.0837
- PMID
- 12008697
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Language
- English
- Date published
- 2002
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984020746702771
Metrics
12 Record Views