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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 22:1757-1760 (October 2001)
© 2001 American Society of Neuroradiology

ARTICLE

Role of Electrothrombosis in Aneurysm Treatment with Guglielmi Detachable Coils: An In Vitro Scanning Electron Microscopic Study

Riccardo Padolecchia^a, Guido Guglielmi^a, Michele Puglioli^a, Maura Castagna^a, Vincenzo Nardini^a, Paolo Luigi Collavoli^a, Giulio Guidetti^a, Mauro Dazzi^a, Vanna Zucchi^a and Piero Narducci^a

^a From the Section of Neuroradiology (R.P., M.P., P.L.C.), Pathology Laboratory, Surgical Department (M.C., V.Z.), and Pathology Section, Oncology Department (V.N.), S. Chiara Hospital; Chemical Engineering and Material Science (P.N.), Pisa University; and the Section of Interventional Neuroradiology (G. Gug., G. Gui.), Department of Neurosciences, Rome La Sapienza University, Pisa, Italy.

BACKGROUND AND PURPOSE: In the 1990s, the introduction of the Guglielmi detachable coil (GDC) system in clinical practice was followed by extensive clinical use of this endovascular device in the treatment of brain aneurysms. This technology is based on electrothrombosis and electrolytic detachment of platinum coils. Despite the extensive use of this treatment technique, the role of electrothrombosis has not been fully investigated and clarified. An in vitro electron microscopic study of human blood was performed to elucidate the role that electrothrombosis might play in triggering the biologic response of thrombosis of the aneurysmal sac.

METHODS: Human blood from five patients was used to fill plastic containers in which GDCs had been deposited. These five patients had subarachnoid hemorrhage and were similar in age and clinical presentation. Electron microscopic studies were performed on GDCs that had been electrically charged and on GDCs that had not.

RESULTS: All electron microscopic studies revealed that the electrically charged GDCs were covered by blood elements and fibrin adherent to the surface of the coil. Noncharged GDCs did not have deposits or adhesions of these blood constituents.

CONCLUSION: These findings demonstrated that passage of electric current through the GDC induces attraction of blood constituents. This attraction may trigger a thrombotic reaction on the surface of the coil. The greater the time of current application, the more pronounced the cellular reaction and the deposition of fibrin and blood cells on the GDC.

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