GDC를 이용한 뇌 동맥류의 방사선학적 치료법

초록

A new method of the endovascular occlusion of the cerebral aneurysm using detachable coil called by GDC(Guglielmi detachable coil) has been developed by Guglielmi in 1991. The mechanisms of GDC treatment are the electrolysis and electrothrombosis. To evaluate the clinical results of GDC treatment, 45 cerebral aneurysms(9 small, 28 large, 8 giant aneurysms) in 42 patients(l0 males, 32 females) were analized. 1 Among total 45 cerebral aneurysms, anterior circulation aneurysms were 28 cases (62.2%) and posterior circulation aneurysms were 17 cases(37.8%). Most common site of cerebral aneurysms was the supraclinoid portion of internal carotid artery (15 cases, 33.3%). The second common site was the tip of basilar artery (6 cases, 13.3%) and the third, the cavernous portion of internal carotid artery(5 cases, 11.1%). 2. Among total 45 cerebral aneurysms, more than 90% occlusions of cerebral aneurysms with GDC were seen in 41 cases(91.1%). 3. Among total 42 patients, 3 patients(7.1%) had major complications by GDC treatment : death due to thrombosis, embolism. arterial dissection. And 3 patients(7.1%) showed temporary arterial occlusions. 4. Among 21 patients who had 6 months follow up study, 17 patients(81.0%) were successful for the treatment and 4 patients(l9.0%) were unsuccessful with coil packing or migration. Endovascular occlusion of cerebral aneurysm with GDC is the promising new technique. It had more advantages compared with the detachable ballon occlusion ; less stress to the wall of the aneurysm, more complete occlusion of the aneurysm lumen. It can be also an alternative or adjunct method to surgical clipping of the aneurysm.