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Query: UMLS:C0220723 (PCA)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

GDC (Guglielmi detachable coil)-embolization for the treatment of brain aneurysms was first published by Guglielmi in 1991 and has become an integral part of the treatment strategy for cerebral aneurysms in many places around the world. Low morbidity and mortality rates are set against the limited possibilities of aneurysm neck occlusion, especially in large necked aneurysms. Depending on the architecture and on the kind of coil distribution, recanalization of the neck is more or less frequent. Nevertheless, rebleeding rates are low. In our series of 211 brain aneurysms from March 1992 to June 1994, 74 (35%) patients underwent GDC-embolization. 4 patients received combined treatment (GDC-embolization and subsequent surgery). Follow-up angiography was performed on 41 patients (55%) at periods of 6, 12, and 24 months (mean follow-up 8 months). To demonstrate the results in a graphic display, the aneurysms were grouped according to location and size. The analysis of the follow-up results shows the highest occlusion stability in aneurysms of the basilar tip, followed by aneurysms of the PICA origin, the basilar trunk and the PCA. Less stability was obtained in aneurysms of the PCom followed by MCA, Acom and aneurysms of the internal carotid (C1, ophthalmic). Aneurysms of the posterior circulation show generally better results than those located in the anterior circulation. This makes (in combination with the increased surgical difficulties of aneurysms in the posterior fossa) the GDC-treatment especially useful for posterior circulation aneurysms.
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PMID:GDC-system embolization for brain aneurysms - location and follow-up. 874 78

Cerebral aneurysms are treated by two methods: direct microsurgical clipping and endovascular coiling. Both are selected based on definite guidelines for clinicoradiological criteria as follows: Endovascular therapy comprising of GDC embolization, CSF wash-out with UK or TP A were performed in cases with Hunt and Kosnik grade 4 (GCS 7, 8), and grade 5 (without hydrocephalus or intracranial hemorrhage), age>70 years, subacute stage (4--14 days of vasospasm), basilar aneurysm and peripheral MCA/PCA aneurysms. Microsurgical clipping with a drainage procedure was performed in cases with Hunt and Kosnik grades 0--3, grade 4 (GCS 9--12), age less than 70 years, grade 5 with hydrocephalus or intracerebral hematoma and acute stage (0--3 days after bleed). The patient's outcome was measured using GOS (Glasgow outcome score) at the time of discharge. In our series of severe (poor grade) SAH cases, 120 cases underwent clipping and 59 cases underwent coiling. Although they accounted for 37.8 % and 48 % of total SAH cases, respectively, the outcome was satisfactory. Good recovery and moderate disability, together termed "favorable outcome" was found in 69.16 % of clipping cases and 44.06 % of coiling cases. Clipping had a better outcome than coiling in cases of acute severe SAH in our series. The golden hour resuscitation, pre-hospital care and the adjunctive treatment strategies like hypothermia are discussed. A critical appraisal of the ISAT of microsurgical clipping versus coiling is used for comparison of our results.
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PMID:The effect of clipping and coiling in acute severe subarachnoid hemorrhage after international subarachnoid aneurysmal trial (ISAT) results. 1617 68