Guglielmi detachable coiling for intracranial aneurysms - The story so far

Spontaneous rupture of cerebral aneurysms typically results in subarachnoid hemorrhage. The primary goal of treatment of cerebral aneurysms is to prev ent future rupture. Surgical clipping had been the mainstay of treatment of both ruptured and unruptured cerebral aneurysms. In 1991, Guglielmi detach able coil (GDC) embolization was introduced as an alternative method for tr eating selected patients with aneurysm. The goal of the treatment is preven t the flow of blood into the aneurysm sack by filling the aneurysm with coi ls and thrombus. Theoretically, there are several advantages of GDC over su rgery. These procedures are performed under general anesthesia with the sta ndard transfemoral approaches used in diagnostic angiography. Since its inc eption, GDC embolization has evolved as a result of both clinical experienc e and the introduction of technological improvements. We are now better at selecting aneurysms appropriate for coiling, which also have wide necks. Ad vances in GDC technology have also improved this method of treatment. Over the last several years, the number of coil sizes has been increased, multid imensional coils allowing safer initial coil placement have become availabl e, and, more recently,softer coils have been introduced. Our current approa ch is to have both surgical and endovascular options for patients.