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AJNR - American Journal of Neuroradiology

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Thromboembolic Events Associated with Guglielmi Detachable Coil Embolization of Asymptomatic Cerebral Aneurysms: Evaluation of 66 Consecutive Cases with Use of Diffusion-Weighted MR Imaging

Akio Soeda^a, Nobuyuki Sakai^a, Hideki Sakai^a, Koji Iihara^a, Naoaki Yamada^b, Satoshi Imakita^b and Izumi Nagata^a

^a Department of Neurosurgery, National Cardiovascular Center, Osaka, Japan
^b Department of Radiology, National Cardiovascular Center, Osaka, Japan

View larger version (31K): [in a new window]   FIG 1. Graph depicts frequency of hyperintense lesions on DW images after the procedure according to A, anatomic configuration and B, procedure performed without (BAT-) or with (BAT+) the balloon-assisted technique. Gray bars indicate symptomatic embolisms; striped bars, silent embolisms; S/S, small aneurysm with small neck; S/W, small aneurysm with wide neck; L, large aneurysm.

View larger version (133K): [in a new window]   FIG 2. Silent embolism in a 63-year-old woman with right internal carotid paraclinoid aneurysm. DW image of the brain obtained 3 days after GDC embolization shows subcortical border-zone infarcts (arrows) in the right hemisphere.

View larger version (145K): [in a new window]   FIG 3. Symptomatic embolism in a 64-year-old woman with basilar bifurcation aneurysm. DW image of the brain obtained 2 days after GDC embolization shows cortical infarcts (arrow) in the left occipital convexity.

View larger version (64K): [in a new window]   FIG 4. Silent embolism not located in the vascular territory of the aneurysm’s parent artery in a 65-year-old woman with basilar bifurcation aneurysm. A–C, DW images of the brain obtained 2 days after GDC embolization show cortical infarcts (arrows) in the cerebellar hemisphere (A) and frontal (B) and parietal (C) convexities.