1994 Volume 22 Issue 1 Pages 35-39
Recently intraaneurysmal thrombosis by microcoils for cerebral aneurysms has been spotlighted because of its easier maneuverability than that of detachable balloons. We report ten cases of intracranial aneurysms in posterior circulation treated with coil embolization. Multiple helical coils were mainly used as the embolic material; flower coils and copper wire were added in some cases. Guglielmi detachable coils were applied in two cases. Complete aneurysmal occlusion was obtained in six cases. The parent artery was patent in all cases. No aneurysms ruptured after the embolization. Distal migration of a coil occurred in two cases, one of which was symptomatic, but there were no other major complications.
The intravascular approach has often been selected for surgically inaccessible aneurysms. It seems to be especially useful for the posterior circulation aneurysms, which are likely to develop serious complications because of their complicated anatomical situation and narrow and deep surgical field. Of various embolic materials, microcoils are more advantageous for aneurysmal embolization than balloons with regard to ease of navigation and guiding, possible with regard to ease of navigation and guiding, possible packing, gentleness for the aneurysmal wall, fewer complications and morbidity, and desirable histopathological reactions. However, usual platinum coils are rarely possible to retrieve and replace when they are inappropriately positioned, and they have a higher risk of distal migration and dislodgement. Detachable coils may resolve these problems according to experimental studies and clinical experiences. Coil embolization appears to be useful for subtentorial aneurysms, and long-term follow-up is needed to appreciate it.
