破裂脳動脈瘤急性期塞栓術の長期成績 : 塞栓状態を中心に(<特集>血管内手術の最先端)  [in Japanese] Clinical Follow-up of Coil-embolized Ruptured Saccular Cerebral Aneurysms(<Topics>Recent Advances in Endovascular Treatment of Aneurysms)  [in Japanese]

We have treated ruptured aneurysms with Guglielmi Detachable Coils (GDC) as the first treatment. Of 575 patients of subarachnoid hemorrhage admitted to our hospital between March 1997 and December 2006, the condition of 201 patients was too poor to be treated. Eighty-eight patients were treated by neck clipping, and 286 cases were treated by GDC embolization. Among the latter patients, 229 (80%) were independent on discharge. During the follow-up period, aneurysmal rerupture occurred in 3 cases (1.5%). And 67 cases (33%) showed change of embolization status. We performed second embolizations in 34 cases (13%) to prevent aneurysmal rerupture. These results suggest that embolization was safe and reliable. But new devices may be necessary to achieve more stable embolization status.