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Research ArticleNeurointervention

Aneurysmal Rupture during Embolization with Guglielmi Detachable Coils: Causes, Management, and Outcome

Arnd Doerfler, Isabel Wanke, Thomas Egelhof, Uwe Dietrich, Siamak Asgari, Dietmar Stolke and Michael Forsting
American Journal of Neuroradiology November 2001, 22 (10) 1825-1832;
Arnd Doerfler
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Isabel Wanke
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Thomas Egelhof
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Uwe Dietrich
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Siamak Asgari
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Dietmar Stolke
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Michael Forsting
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    fig 1.

    Case 1.

    A, Lateral projection arteriogram of the left internal carotid artery reveals a posterior communicating artery aneurysm.

    B, Lateral projection arteriogram of the left internal carotid artery, obtained immediately after aneurysm rupture that occurred after placement of the first coil, shows the rupture and massive extravasation of contrast material.

    C, Selective angiogram obtained via the microcatheter.

    D, Axial view CT scan obtained after clip placement in the aneurysm shows massive brain edema and contrast agent in the subarachnoid space.

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    fig 2.

    Case 2.

    A, Frontal projection arteriogram of the left vertebral artery shows a basilar tip aneurysm.

    B, Frontal projection arteriogram of the right vertebral artery, obtained after placement of two GDCs, reveals slight extravasation of contrast material (magnification).

    C, Frontal projection arteriogram of the left vertebral artery shows complete embolization of the basilar artery tip aneurysm.

    D, Axial view CT scan depicts slight extravasation of contrast agent and blood.

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    fig 3.

    Case 3.

    A, Frontal projection arteriogram of the right internal carotid artery shows a small, caudally oriented anterior communicating artery aneurysm.

    B and C, Arteriograms of the right internal carotid artery, obtained after placement of one GDC, show that the coil partially protrudes into the subarachnoid space.

    D, Axial CT scan, obtained before endovascular treatment, shows SAH and extravasation of contrast material after aneurysm perforation.

    E, Axial CT scan, obtained after endovascular treatment, shows SAH and extravasation of contrast material after aneurysmal perforation.

    F, Control angiogram, obtained 4 wk after endovascular treatment, reveals the aneurysm remnant.

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    fig 4.

    Case 5.

    A–C, Frontal projection arteriograms of the right internal carotid artery show an anterior communicating artery aneurysm before and after placement of three GDCs, with complete occlusion of the aneurysm.

    D and E, Time-of-flight MR angiograms, obtained 2 d after endovascular treatment, confirm complete occlusion and do not reveal any thrombosed portions of the aneurysm.

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    TABLE 1:

    Clinical data, causes, and outcomes in five patients with aneurysm rupture during embolization

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American Journal of Neuroradiology: 22 (10)
American Journal of Neuroradiology
Vol. 22, Issue 10
1 Nov 2001
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Cite this article
Arnd Doerfler, Isabel Wanke, Thomas Egelhof, Uwe Dietrich, Siamak Asgari, Dietmar Stolke, Michael Forsting
Aneurysmal Rupture during Embolization with Guglielmi Detachable Coils: Causes, Management, and Outcome
American Journal of Neuroradiology Nov 2001, 22 (10) 1825-1832;

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Aneurysmal Rupture during Embolization with Guglielmi Detachable Coils: Causes, Management, and Outcome
Arnd Doerfler, Isabel Wanke, Thomas Egelhof, Uwe Dietrich, Siamak Asgari, Dietmar Stolke, Michael Forsting
American Journal of Neuroradiology Nov 2001, 22 (10) 1825-1832;
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  • Safety and efficacy of management for intraprocedural rupture during endovascular treatment for intracranial aneurysms
  • Vessel perforation during stent retriever thrombectomy for acute ischemic stroke: technical details and clinical outcomes
  • Cerebral aneurysm wall thickness analysis using intraoperative microscopy: effect of size and gender on thin translucent regions
  • Endovascular coil embolization of a very small ruptured aneurysm using a novel microangiographic technique: technical note
  • A checklist for cerebral aneurysm embolization complications
  • Intraprocedural Aneurysmal Rupture during Coil Embolization of Brain Aneurysms: Role of Balloon-Assisted Coiling
  • Repair of intracranial vessel perforation with Onyx-18 using an exovascular retreating catheter technique
  • A Checklist in the Event of Aneurysm Perforation during Coiling
  • Clinical and Angiographic Results of Coiling of 196 Very Small (<= 3 mm) Intracranial Aneurysms
  • Predictors and Outcomes of Intraprocedural Rupture in Patients Treated for Ruptured Intracranial Aneurysms: The CARAT Study
  • Intravenous Administration of Acetylsalicylic Acid During Endovascular Treatment of Cerebral Aneurysms Reduces the Rate of Thromboembolic Events
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