Embolization of collateral veins is often treated with rigid coils(Gianturco and interlocking detachable coils type).However,when dealing with tortuous and dilated collateral veins,there is a high risk for technical f...Embolization of collateral veins is often treated with rigid coils(Gianturco and interlocking detachable coils type).However,when dealing with tortuous and dilated collateral veins,there is a high risk for technical failure and coil migration due to inflexibility of the coils.To safely and successfully solve this problem,Guglielmi detachable coils(GDC) can be used for embolization.Their flexibility allows for easy navigation in tortuous veins,low risk of unintended coil release or coil migration,and safe deployment.A 12-year-old girl with a single ventricle had severe cyanosis and a low exercise tolerance 5 years after Fontan procedure.The symp-toms were caused by a tortuous and dilated collateral from the left phrenic vein into the left pulmonary vein,forming a right-to-left shunt.The collateral,which had a large diameter and high flow,and therefore a high risk of coil migration,was successfully embolized with 8 GDC.There were no complications such as coil migration or cerebral infarction.Transcatheter embolization increased her systemic oxygen saturation from 81%-84% to 94%-95%,and increased her ability to exercise.The embolization procedure using flexible GDC was low risk compared with other rigid coil embolization techniques when performing embolization of tortuous and dilated collateral veins.展开更多
Objective.To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals(MDS) and with Guglielmi detachable coils(GDC).Methods.One hundred and twenty cases with 125 intracranial aneur...Objective.To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals(MDS) and with Guglielmi detachable coils(GDC).Methods.One hundred and twenty cases with 125 intracranial aneurysms were embolized in Beijing Hospital from March 1995 to July 1999.Sixty-six aneursms in 64 cases were embolized with MDS,51 in 48 with GDC, and 8 in 8 with both MDS and GDC.Clinical data includng sex,age,subarachnoid hemorrhage(SAH),Hunt & Hess grading,diameter and neck width of aneurysms,number and length of coils used per aneurysm,occlusive radio,and complications were compared between MDS and groups.Results.MDS and GDC groups were comparable(t-test or X^2 -test ,all P value>0.10） in terms of age,sex,diameter of aneurysms[(8.46±3.42)mm vs.(7.38±3.45)mm],neck width[(3.49±1.50)mm vs.（3.26±1.52)mm],coils number [(4.65±3.01)vs.(4.24±2.65)] and their length[(460.2±398.5)mm vs.(422.9±387.1)mm] used per aneurysm,occlusive ratio in aneurysms embolized≥80%[(95.00±6.32%)vs.(94.19%±7.63%)],mortality and permanent complications(7.8% vs.4.25）。Couclusions,MDS and GDC are all materials for embolization of intracranial aneurysms.MDS is less expensive,but more difficult to control and of propensity to complications while GDC is more compliant ,easier to be used,safer,and have many alternative types for use as well as more extensive indications.展开更多
文摘Embolization of collateral veins is often treated with rigid coils(Gianturco and interlocking detachable coils type).However,when dealing with tortuous and dilated collateral veins,there is a high risk for technical failure and coil migration due to inflexibility of the coils.To safely and successfully solve this problem,Guglielmi detachable coils(GDC) can be used for embolization.Their flexibility allows for easy navigation in tortuous veins,low risk of unintended coil release or coil migration,and safe deployment.A 12-year-old girl with a single ventricle had severe cyanosis and a low exercise tolerance 5 years after Fontan procedure.The symp-toms were caused by a tortuous and dilated collateral from the left phrenic vein into the left pulmonary vein,forming a right-to-left shunt.The collateral,which had a large diameter and high flow,and therefore a high risk of coil migration,was successfully embolized with 8 GDC.There were no complications such as coil migration or cerebral infarction.Transcatheter embolization increased her systemic oxygen saturation from 81%-84% to 94%-95%,and increased her ability to exercise.The embolization procedure using flexible GDC was low risk compared with other rigid coil embolization techniques when performing embolization of tortuous and dilated collateral veins.
基金This work was originally published in the Chinese Journal of Neuro-surgery (2001 17(2): 87-90) in Chinese.
文摘Objective.To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals(MDS) and with Guglielmi detachable coils(GDC).Methods.One hundred and twenty cases with 125 intracranial aneurysms were embolized in Beijing Hospital from March 1995 to July 1999.Sixty-six aneursms in 64 cases were embolized with MDS,51 in 48 with GDC, and 8 in 8 with both MDS and GDC.Clinical data includng sex,age,subarachnoid hemorrhage(SAH),Hunt & Hess grading,diameter and neck width of aneurysms,number and length of coils used per aneurysm,occlusive radio,and complications were compared between MDS and groups.Results.MDS and GDC groups were comparable(t-test or X^2 -test ,all P value>0.10） in terms of age,sex,diameter of aneurysms[(8.46±3.42)mm vs.(7.38±3.45)mm],neck width[(3.49±1.50)mm vs.（3.26±1.52)mm],coils number [(4.65±3.01)vs.(4.24±2.65)] and their length[(460.2±398.5)mm vs.(422.9±387.1)mm] used per aneurysm,occlusive ratio in aneurysms embolized≥80%[(95.00±6.32%)vs.(94.19%±7.63%)],mortality and permanent complications(7.8% vs.4.25）。Couclusions,MDS and GDC are all materials for embolization of intracranial aneurysms.MDS is less expensive,but more difficult to control and of propensity to complications while GDC is more compliant ,easier to be used,safer,and have many alternative types for use as well as more extensive indications.
