Endovascular Treatment of Intracranial Aneurysms with Electrolytically Detachable Platinum Coils

Abstract

The incidence of intracranial aneurysms has been estimated to be one to eight per cent of the general population. The most common complication of intracranial aneurysms is rupture with subsequent subarachnoid hemorrhage (SAH), resulting in significant morbidity and mortality. The definitive treatment for SAH in the past has been neurosurgical clipping of the aneurysms to
prevent rebleeding. With the development of endovascular techniques in the seventies came an alternative to surgery for patients whose aneurysms were not favorable for clipping and for patients not medically stable enough to tolerate surgery. Of the endovascular techniques, embolization through the use of electrolytically detachable platinum coils appears to be the most promising. This procedure utilizes the electrochemical principles of electrolysis and
electrothrombosis to facilitate selec-tive occlusion of intracranial aneurysms while sparing circulation in the parent artery. Evidence of the efficacy of these coils in ruptured intracranial aneurysms has been established in a large multicentered trial. Further investigation, however, is needed to determine the role this endovascular technique will play in first and second line treatment for both ruptured and unruptured intracranial aneurysms.