J Korean Neurosurg Soc.  2013 Jul;54(1):19-24. 10.3340/jkns.2013.54.1.19.

Thromboembolic Events Associated with Electrolytic Detachment of Guglielmi Detachable Coils and Target Coils : Comparison with Use of Diffusion-Weighted MR Imaging

• Kim MJ
• Lim YC
• Oh SY
• Kim BM
• Kim BS
• Shin YS

• KMID: 2190852
• DOI: http://doi.org/10.3340/jkns.2013.54.1.19

Abstract

OBJECTIVE
The purpose of this study was to retrospectively evaluate and compare the incidence of diffusion-weighted image (DWI) lesions between the Guglielmi detachable coil (GDC) and the Target coil for treating unruptured intracranial aneurysm.
METHODS
From 2010 to 2011, consecutive 222 patients with an intracranial aneurysm underwent coil embolization. Inclusion criterias were : 1) unruptured intracranial aneurysm, 2) one or more GDC or Target coils used with or without other coils, 3) DWI examination within 24 hours after coiling, and 4) coiling performed without a balloon or stent.
RESULTS
Ninety patients (92 cases) met the inclusion criteria. DWI lesions were detected in 55 (61.1%) of 90 patients. In the GDC group (n=44), DWI lesions were detected in 31 (70.5%). The average number of DWI lesions was 5.0+/-8.7 (mean+/-SD; range, 1-40) in aneurysm-related territory. In the Target coil group (n=48), DWI lesions were detected in 24 (50.0%). The number of DWI lesion was 2.1+/-5.4 (range, 1-32) in aneurysm-related territory. There was no significant correlation between a number of coils and DWI lesions. No significant differences were also observed in the number of DWI lesions in each group.
CONCLUSION
The GDC and Target coils, which have an electrolytic detachable system, showed no differences in the incidence of DWI lesion.

Keyword

Air bubble; Coil embolization; Diffusion-weighted imaging; Detachable coil; Thromboembolism

MeSH Terms

Humans
Incidence
Intracranial Aneurysm
Magnetic Resonance Imaging
Retrospective Studies
Thromboembolism

Figure

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  Fig. 1 Microscopic photographs of electrolytic detachment process of GDC-10 SynerG (A) and Target detachable coil (B) in heparinized saline. Multiple and variable sized bubbles are generated around the detachment zone. GDC: Guglielmi detachable coil.

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  Fig. 2 Flow diagram for patient selection. GDC: Guglielmi detachable coil, DWI: diffusion-weighted image.

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  Fig. 3 A: A 53-year-old female patient with an unruptured left PICA aneurysm sized about 4 mm on a three-dimensional reconstruction image. B: The coil embolization using three GDCs without supporting materials has been performed completely for the aneurysm. C and D: Several high signal dots are detected in ipsilateral PICA territory on DWI. PICA: posterior inferior cerebellar artery, GDC: Guglielmi detachable coil, DWI: diffusion-weighted image.

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  Fig. 4 The number of the aneurysm-related DWILs and coil embolization results for the aneurysms based on number of the GDC (A) or Target coil (B) of total detachable coils. There is no significance between A and B (p=0.704). Partial correlation coefficient (r) adjusted by aneurismal size and occlusion results. DWIL: diffusion-weighted imaging positive lesion. DWIL: diffusion-weighted imaging positive lesion, GDC: Guglielmi detachable coil.

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