The road not taken

摘要

In 1991 Guido Guglielmi et al in the first of two manuscripts reported the basic functioning of detachable coils.1 In the second article, the authors demonstrated aneurysmal thrombosis in 70-100% of their 15 patients treated with this new technology.2 On 8 September 1995, the Food and Drag Administration approved commercial sale of the Guglielmi detachable coils (GDC). Unquestionably, GDC started a revolution in neurosurgery by changing forever the way we treat cerebral aneurysms. In 2002, the Lancet published the results of International Subarachnoid Aneurysm Trial (ISAT).3 The absolute risk reduction for dependency or death in the endovascular group was 6.9% and the relative risk reduction was 22.6%. At 1 year, the absolute risk reduction was 7.4%.