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AJNR - American Journal of Neuroradiology

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Effect of Guglielmi Detachable Coils on Intraaneurysmal Flow: Experimental Study in Canines

Angelika Sorteberg^a, Wilhelm Sorteberg^a, Alan Rappe^b and Charles M. Strother^b

^a Department of Neurosurgery, Rikshospitalet, National Hospital, Oslo, Norway
^b Department of Radiology, University of Wisconsin Health Sciences Center Madison

View larger version (126K): [in a new window]   FIG 1. DSA image shows the experimental aneurysm model used in this study. Guidewires that were used to measure the temperature and pressure is present in the bifurcation aneurysm (short arrowhead) and parent artery (long arrowhead).

View larger version (16K): [in a new window]   FIG 2. Pressure-thermodilution tracings during an injection of sodium chloride solution over 2 seconds (20 mL/s). At the time of the injection, increase in pressure increases suddenly and quickly; this change is followed by a decrease in temperature. The return of the temperature returns to baseline values is slightly slower than that of pressure. temp indicates the maximum decrease in temperature; T temp, time required to obtain the maximum decrease in temperature; and , shift between the observed increases in pressure and flow.

View larger version (37K): [in a new window]   FIG 3. Pressure-thermodilution tracings of injections of sodium chloride solution over 2 seconds (20 mL/s) and 4 seconds (5 mL/s). Higher volumes create a larger increases in pressure but similar decreases in temperature. The length of the dilution interval and pressure increase is dependent on the duration of injection. This finding illustrates the ability to assess flow by using only an injection of only 5 mL/s.

View larger version (28K): [in a new window]   FIG 4. Pressure-thermodilution tracings of injections of 20 mL/s sodium chloride solution over 2 seconds in the dome of the aneurysm before, during, and after complete GDC placement. The thermodilution trace is markedly flattened; this finding corresponds to a cessation of local blood flow. Pressure is not attenuated. This result illustrates that insertion of only a single coil can dramatically change flow within an aneurysm. Further coil placement in this aneurysm completely interrupted flow in the aneurysm.

View larger version (22K): [in a new window]   FIG 5. Pressure-thermodilution tracings of injections of 20 mL/s sodium chloride solution over 2 seconds in the dome of the aneurysm before and after complete GDC placement demonstrate the resulting dissociation of pressure and flow. Compare the interval between the injection and change in temperature before coil placement to that observed after coil placement.