INITIAL COMPARISON OF INTRACRANIAL ANEURYSM EMBOLIZATION WITH MECHANICAL DETACHABLE SPIRALS AND WITH GUGLIELMI DETACHABLE COILS

摘要

Objective. To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals (MDS) and with Guglielmi detachable coils (GDC). Methods. One hundred and twenty cases with 125 intracranial aneurysms were embolized in Beijing Hospital from March 1995 to July 1999. Sixty - six aneurysms in 64 cases were embolized with MDS, 51 in 48 with GDC, and 8 in 8 with both MDS and GDC. Clinical data including sex, age, subarachnoid hemorrhage (SAH), Hunt & Hess grading, diameter and neck width of aneurysms, number and length of coils used per aneurysm, occlusive ratio, and complications were compared between MDS and GDC groups. Results. MDS and GDC groups were comparable (t-test or χ~2 -test, all P value > 0. 10) in terms of age, sex, diameter of aneurysms [ (8. 46 +- 3. 42) mm vs. (7. 38 +- 3. 45) mm], neck width [ (3. 49 +- 1. 50) mm vs. (3. 26 +- 1. 52) mm], coils number[(4. 65 +- 3. 01 ) vs. (4. 24 +- 2. 65)] and their length[(460. 2 +- 398. 5) mm vs. (422. 9 +- 387. 1) mm] used per aneurysm, occlusive ratio in aneurysms embolized ≥ 80% [(95.00% +-6. 32% ) vs. (94. 19% +- 7. 63% )], mortality and permanent complications (7. 8% vs. 4. 2% ). Conclusions. MDS and GDC are all materials for embolization of intracranial aneurysms. MDS is less expensive, but more difficult to control and of propensity to complications while GDC is more compliant, easier to be used, safer, and have many alternative types for use as well as more extensive indications.