Absent Relationship between the Coil-Embolization Ratio in Small Aneurysms Treated with a Single Detachable Coil and Outcomes
James K. Goddarda,
Christopher J. Morana,
DeWitte T. Cross, IIIa and
Colin P. Derdeyna
a From the Neuroradiology Section (Interventional Neuroradiology), Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
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FIG 1. Stable aneurysm, patient 14, a 55-year-old man with multiple nonruptured aneurysms.
A, Lateral right common carotid arteriogram demonstrating a 4-mm posterior communicating artery region aneurysm and a carotid bifurcation aneurysm.
B, Lateral posttreatment arteriogram demonstrating nonfilling of both aneurysms. The posterior communicating aneurysm was treated with a single GDC-10 2.5-mm x 4-mm ultrasoft coil, resulting in a CER of 2.4%.
C, One-year follow-up arteriogram reveals obliteration of both aneurysms.
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FIG 2. Small recurrence, patient 12, a 46-year-old woman with a ruptured 3-mm basilar apex aneurysm.
A, Lateral vertebral arteriogram showing the 3-mm anteriorly directed basilar apex aneurysm.
B, Lateral vertebral arteriogram immediately after treatment with a single GDC-10 2.5-mm x 6-cm ultrasoft coil showing the nonfilling of the aneurysm. The CER was 8.6%.
C, Six-month follow-up lateral vertebral arteriogram reveals a small recurrence at the base of the aneurysm.
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FIG 3. Large recurrence, patient 18, a 53-year-old man with a ruptured anterior communicating artery aneurysm.
A, Frontal waters right carotid arteriogram showing a 2.5-mm anterior communicating aneurysm.
B, Immediate posttreatment image reveals obliteration with a single GDC-10 2-mm x 8-mm soft coil. The CER was 21.1%
C, Surveillance arteriogram 2 months later shows coil compaction and a 6 x 10 mm recurrence.
D, Nonsubtracted single oblique waters image shows the compacted single coil at the periphery of the aneurysm as well as stagnant contrast and thrombus within the aneurysm.
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