GDC 360 degrees for the endovascular treatment of intracranial aneurysms: a matched-pair study analysing angiographic outcomes with GDC 3D Coils in 38 patients

Abstract

Introduction: The purpose of this study was to determine whether coil embolisation with a new complex-shaped Guglielmi Detachable Coil (GDC 360 degrees; Boston Scientific Neurovascular, Fremont, CA, USA) has any effect on the stability of aneurysm occlusion.

Materials and methods: Fifty-one consecutive patients with intracranial aneurysms treated with GDC 360 degrees were included. Angiographic results and adverse neurological events during the follow-up period were recorded. For 38 patients treated with GDC 360 degrees with available follow-up data, a corresponding patient treated with GDC 3D was identified from our database. Matches were sought for rupture status, location, aneurysmal size, and neck size. The angiographic outcome of these matched controls at 6 months was compared to aneurysms treated with GDC 360 degrees.

Results: Initial angiographic controls for 38 patients treated with GDC 360 degrees showed complete occlusion in 32 aneurysms, and a neck remnant in six. At 6-month follow-up, complete occlusion was found in 29, a neck remnant in eight, and a residual aneurysm in one. One patient treated with GDC 360 degrees needed retreatment for a major recanalisation. In 38 matched patients treated with GDC 3D, initial angiographic controls found complete aneurysmal occlusion in 30 aneurysms and a residual neck in 8. At 6-month follow-up, 24 aneurysms were completely occluded, ten showed a neck remnant, and residual aneurysms were seen in four. Four patients, treated with GDC 3D, were retreated for major aneurysm recanalisations.

Conclusion: Our data suggests that endovascular coil embolisation with GDC 360 degrees might improve long-term stability of coiled aneurysms when compared to GDC 3D.