Transarterial platinum coil occlusion of ruptured intracranial aneurysms: results in 51 patients

Fifty-one patients with subarachnoid haemorrhage (SAH) due to ruptured intr acranial aneurysm have been treated by the Guglielmi detachable platinum co il (GDC) treatment method; 36 patients within 28 days of the ictus. There w as total body occlusion in 64.8%, subtotal body occlusion in 24.1% and fail ed coil placement in 11.1%. Technical success rates were highest in aneurys ms with neck sizes up to 4 mm (75% total occlusion) and aneurysms smaller t han 10 mm largest diameter (72.5% total occlusion). At discharge from prima ry care, there were 62.7% without deficit rising to 74.5% at follow-up asse ssment. Four patients are dead and one disabled (9.8%). Patient clinical ou tcomes relate most closely to Hunt and Hess grade at time of definitive tre atment. Higher initial grades and poorer clinical outcomes are concentrated in patients treated in the first 14 days. The incidence of procedure relat ed 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 p atients treated 1-14 days post SAH.