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Treatment of an Intracranial Aneurysm Using a New Three-Dimensional-Shape Guglielmi Detachable Coil: Technical Case Report

Malek, Adel M. M.D., Ph.D; Higashida, Randall T. M.D.; Phatouros, Constantine C. F.R.A.C.R.; Dowd, Christopher F. M.D.; Halbach, Van V. M.D.

Technical Case Report

OBJECTIVE AND IMPORTANCE: Coil embolization of wide-necked aneurysms is currently difficult, when using a conventional endovascular approach without resorting to complex adjunctive techniques.

CLINICAL PRESENTATION: A 41-year-old woman with a history of systemic lupus erythematosus and hypertension refractory to treatment presented with an unruptured right ophthalmic segment aneurysm of the internal carotid artery having an unfavorable neck-to-fundus ratio.

INTERVENTION: A new type of Guglielmi detachable coil (Target Therapeutics, Fremont, CA), consisting of a series of omega loops, spontaneously forms a three-dimensional cage after deployment and was used to successfully treat the aneurysm, which was angiographically stable at the 3-month follow-up.

CONCLUSION: The new Guglielmi detachable coil may be useful in the embolization of aneurysms having an unfavorable geometry, which would otherwise not be amenable to endovascular treatment without adjunctive techniques.

Departments of Radiology (AMM, RTH, CCP, CFD, VVH), Division of Interventional Neurovascular Radiology, and Neurological Surgery (RTH, CFD, VVH), University of California, San Francisco, San Francisco, California

Received, October 14, 1998. Accepted, December 23, 1998.

Reprint requests: Adel M. Malek, M.D., Ph.D., Interventional Neuroradiology, University of California, San Francisco, Box 0628, Room L352, 505 Parnassus Avenue, San Francisco, CA 94143.

Copyright © by the Congress of Neurological Surgeons