Long-Term Follow-up Of Cerebral Aneurysms Treated By Guglielmi Detachable Coiling

Objective This study was to evaluate the security, feasibility and stability of occlusion of aneurysms and to assess the rate of recanalization and retreatment of these aneurysms.Methods Between January 2006 and January 2011, 158 patients with 167 aneurysms were treated consecutively with GDC coils in the neuroradiology center of Affiliated Hospital of Ningxia Medical University.All patients preoperatively underwent digital subtraction angiography(DSA)to understand the aneurysm size, location, shape, direction, vascular conditions, the availability of multiple aneurysms. After completion of surgery, all patients underwent DSA immediately and record the effect of aneurysm embolization. Then all patients were regularly followed by DSA at 3 months, 12 months, and 4 to 5 years after treatment. The follow-up angiogram and the initial angiogram of aneurysms were compared to see whether the aneurysm occlusion changes, and then to evaluate the effect of aneurysm embolization.The angiographic results of coil occlusion were classified as complete, near-complete, or incomplete by using the modified Raymond classification scale. And we obtained the long-term clinincal follow-up result by telephone.Results Initial acute angiographic results in 167 aneurysms demonstrated total occlusion in 102 aneurysms (61.1%), subtotal occlusion in 52 (31.1%), incomplete occlusion in 5 (3.0%), and failures in 8 (4.8%) aneurysms. A remodeling technique was used in 16.8%. A second procedure was performed for 11 aneurysms (6.6%). Only 3(2.2%) aneurysms re-bled during 5 years of follow-up. Long-term follow-up angiograms were obtained in 135 aneurysms, with 97(71.9%) total, 35(25.9%) subtotal, and 3(2.2%)incomplete results. The modified Rankin Scale score was 0～2 in 87.6%,3～6 in 12.4%. Conclusion (1) Use of Guglielmi detachable coiling(GDC)is a safe and feasible technique. (2) Only 2.2% of the aneurysms were retreated. (3) Use of GDC gives a good long-term level of occlusion. (4) Use of GDC gives a good long-term clinical result.