Guglielmi detachable coil embolization of intracranial aneurysms

Abstract

Today, the Guglielmi Detachable Coil (GDC) technique is the primary endovascular modality used for the endovascular occlusion of intracranial aneurysms carrying a high surgical risk of morbidity and mortality. 1,2 Balloon embolization of aneurysms is only used in those cases requiring parent artery occlusion such as in giant skull base and intracerebral aneurysms. 3 The endovascular occlusion of aneurysms using detachable balloons has now been abandoned because of its high technical and clinical complication rate. 4 Electrolytically detachable microcoils were developed by Guglielmi et al. at UCLA Medical Center in 1989 and used in patients at the beginning of 1990. The coils are constructed of soft platinum with different diameters and lengths and are deposited within an aneurysm through a soft guiding microcatheter. The platinum coil is then detached from the stainless steel guidewire by applying a small current of I mA for approximately I minute. The aneurysm is packed with GDC coils until it is completely isolated from the circulation. The anatomic results using this technology depend mainly on the diameter of the aneurysm and the size of its neck (Fig 1).