Guglielmi Detachable Coil

A Guglielmi Detachable Coil or GDC ( Guglielmi Detachable spiral ) is a platinum coil, which is commonly used for the closure of cerebral artery aneurysms. This soft, stretched hair-thin platinum coils are endovascular put forward with a microcatheter to the aneurysm and placed in the aneurysm inside where they take back their spiral shape and form ball. The method, which is also called coiling or endovascular aneurysm occlusion was first used in 1990 by the Italian neurosurgeon Dr Guido Guglielmi and learned in the 1990s, is used widely as an alternative to surgical clipping of the blood vessels. Since the approval of the procedure in Germany in 1995, several thousand patients have been treated.

Method

The operation of the coils is based on two principles: first, take the platinum coils after detachment from the catheter due to the memory effect immediately return to their original shape, on the other hand they can be easily removed by low current from the load-bearing catheter. There are inserted as many platinum coils, that the interior of the aneurysm is filled as far as possible. The procedure itself and the success of the measure will be evaluated by angiographic images. The effect of coiling as elimination of the aneurysm from the blood circulation is in a short-term effect, namely the stasis and thrombosis of blood between the Coilmaschen, and a long-term effect, which in gewebigen remodeling in aneurysm and in the endothelialization of Coilgrenze the actual blood vessel exists and takes several weeks to complete.

The coiling is only suitable for aneurysms with a relatively narrow neck ( approximately pear -shaped). Aneurysms with a relatively wide neck can not or only with the help of remodeling techniques are supplied with coils, since the risk is great that the coils happen out of the aneurysm into the parent artery and can close this or washed by the blood stream into closer vessels are. Whether the prognosis of patients after coiling as compared to surgical treatment (clipping ) is better, is controversial and must be decided on an individual basis by the treating physicians. A meta-analysis published in 2005 found only for patients with a ruptured ( torn ) aneurysm who were in good clinical condition a better outcome after coiling.

Benefits

The coiling is a minimally invasive procedure associated with less intraoperative risks than open neurosurgical treatment of aneurysms. Also aneurysms surgically difficult or impossible to achieve, can thus be eliminated. According to a meta - analysis published in 2006, however, the occurrence of vasospasm after insertion of GDCs as often as after open surgical intervention.

Risks

When Vorbringung and placement of GDCs via catheter, it may result in the formation or mobilization of thrombi and perforation of the vessel wall. Furthermore, as with any invasive measures the risk of infection.

There is also the risk that the aneurysm and revascularization can lead to bleeding again.