Impact of Guglielmi detachable coils on outcomes of patients with intracranial aneurysms treated by a multidisciplinary team at a single institution

Object. The goal of this study was to investigate the impact of the introdu ction of the Guglielmi detachable coil (GDC) therapeutic option on the over all management outcome of intracranial aneurysms. The authors accomplished this by assessing patient morbidity and mortality, inflation-adjusted hospi tal charges, lengths of stay in the hospital and the intensive care unit (I CU), and treatment efficacy. Methods. The authors conducted a retrospective analysis of consecutive case s of intracranial intradural aneurysms managed by a single multidisciplinar y neurovascular team at a tertiary care, academic referral center during th e 24 months preceding the introduction of the GDC procedure (Group I or pre -GDC era, 77 patients) and during the first 24 months after its introductio n (Group II or GDC era, 99 patients). Treatment with GDCs was considered for cases of higher clinical grade or po or surgical risk; or in response to patient preference (27 [27%] of 99 pati ents in Group II). Host and lesion parameters in our cohort were validated against outcome parameters by using univariate and multivariate analyses. T he pre-GDC and GDC subgroups of patients were comparable for major disease severity parameters (patient age, lesion location, clinical grade, and hemo rrhage severity). There was no significant difference in clinical outcome a t 6 months, infarcts on computerized tomography scanning, or aneurysm oblit eration rates before and after introduction of GDC treatment. Decreasing tr ends in duration of hospital and ICU stay and in inflation-adjusted hospita l charges occurred well before and thus were unrelated to the introduction of the GDC therapeutic option. Conclusions. The results of this study do not demonstrate any significant i mpact of integration of the GDC modality on clinical outcome, mortality, mo rbidity, or effectiveness of treatment. Ongoing improvements in hospital ch arges and length of hospital stay appeared unrelated to the introduction of the GDC option.