Histological Findings in Ruptured Aneurysms Treated with GDCs: Six Examples at Varying Times after Treatment
Christoph Grodena,
Christian Hagelb,
Guenter Dellingc and
Hermann Zeumera
a Departments of Neuroradiology, University Hospital Eppendorf, University of Hamburg, Hamburg, Germany
b Neuropathology, University Hospital Eppendorf, University of Hamburg, Hamburg, Germany
c Osteopathology, University Hospital Eppendorf, University of Hamburg, Hamburg, Germany
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FIG 1. Distribution of platinum coils in a plasticized medial cerebral artery aneurysm is shown by this arbitrarily chosen 250-µm-thick section from case 1 (see Table 1). The scale can be extrapolated from the coil diameter of 0.010 in.
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FIG 2. Exemplary short-term results from case 1, in which death occurred 5 days after treatment (see Table 1).
A, Angiogram obtained before treatment of a medial cerebral artery aneurysm.
B, Angiogram obtained after GDC treatment of a medial cerebral artery aneurysm.
C, Histologic 5- to 10-µm-thick section of plasticized aneurysm 5 days after treatment depicts a thrombus consisting of fibrin and erythrocytes. The scale can be extrapolated from the coil diameter of 0.01 in.
D, x10 magnification of the inset shown in C depicts fibrin clotting and erythrocytes (arrows).
E, x40 magnification of the inset shown in D depicts single macrophages (arrow).
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FIG 3. Exemplary mid-term results from case 3, in which death occurred 13 days after treatment (see Table 1).
A, Angiogram obtained before treatment of an anterior communicating artery aneurysm.
B, Angiogram obtained after GDC treatment of an anterior communicating artery aneurysm.
C, Histologic 5- to 10-µm-thick section of plasticized aneurysm 13 days after treatment shows thrombus extending into the parent vessel (arrows). The scale can be extrapolated from the coil diameter of 0.010 in.
D, x20 magnification of the inset in shown in C depicts that the thrombus projecting into the feeding vessel is partially coated with endothelium (arrows).
E, x100 magnification of the area in C indicated by the dashed lines depicts foamy giant cells between the platinum coils (arrow).
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FIG 4. Exemplary long-term results from case 6, in which death occurred 272 days after treatment (Table 1).
A, Angiogram obtained before treatment of a basilar tip aneurysm.
B, Angiogram obtained after treatment of a basilar tip aneurysm.
C, Histologic 5- to 10-µm-thick section of plasticized aneurysm depicts scar-like connective tissue in the former aneurysm lumen 272 days after treatment. The scale can be extrapolated from the two coil diameters of 0.010 and 0.015 in.
D, x20 magnification of the red inset shown in C depicts vascularized connecting tissue surrounding platinum coils (arrow).
E, x40 magnification of the white inset shown in C depicts foreign body giant cells with multiple nuclei adjacent to coils (arrows).
F, x10 magnification of the area indicated by the dashed lines depicts scar tissue covered by a layer of long slender cells, resembling endothelium, demarcating the aneurysm orifice against the parent vessel (arrows).
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