Intracranial Aneurysms Treated with Guglielmi Detachable Coils: Midterm Clinical and Radiological Outcome in 97 Consecutive Chinese Patients in Hong Kong

Simon C. H. Yu, Michael S. Y. Chan, Ronald Boet, Jeffrey K. T. Wong, Joseph M. K. Lam, and Wai S Poon

Abstract

BACKGROUND AND PURPOSE: Use of Guglielmi detachable coils (GDCs) has proved to be a promising endovascular treatment for intracranial aneurysms. This study aimed to evaluate midterm clinical and radiologic outcomes of this treatment in Hong Kong Chinese patients, 68% of whom had small aneurysms (≤5 mm).

METHODS: We included 97 consecutive patients in whom GDCs were placed with curative intent. The patients presented with subarachnoid hemorrhage (n = 80) or mass effect (n = 17). The aneurysms measured 5 cm ± 2.8 mm; 68% were ≦5 mm. All patients were followed up clinically for an average of 54.5 ± 20.9 months and radiologically with sequential digital subtraction angiography at 6 and 18 months.

RESULTS: Total occlusion of the aneurysm was successfully achieved in 71.1% of patients after the initial treatment and in 82.5% after subsequent treatments. The retreatment rate was 17.5%. Procedure-related complication and mortality rates were 11.3% and 0%, respectively. The overall mortality was 5%, including mortality due to treatment failure in 1%. Neurologic outcomes were excellent in 77% of patients. Improved neurologic status, unchanged status, and deteriorated status was noted in 61.5%, 22%, and 16.5% of patients, respectively, at the end of the follow-up period. Intrinsic differences existed between Chinese and Western patients regarding the size of the aneurysm at presentation, periprocedural complications, and progression patterns of anatomic outcomes.

CONCLUSION: Endovascular coiling with GDCs is a reasonably effective and safe treatment for intracranial aneurysms in this group of Hong Kong Chinese patients, with favorable clinical and radiologic outcomes.

Abstract: http://www.ajnr.org/content/25/2/307.abstract