Effect of Guglielmi detachable coils on intraaneurysmal flow: experimental study in canines.

BACKGROUND AND
PURPOSE: Guglielmi detachable coils (GDCs) are effective in preventing rebleeding of ruptured aneurysms. To better understand the mechanism underlying this protective effect, we evaluated blood flow in aneurysms and their parent arteries before and after GDC coil placement.
METHODS: An 0.14-inch guidewire containing a combined pressure and thermistor sensor was inserted through a microcatheter into both the parent artery and the dome of surgically created canine aneurysms. Before and after GDC coil placement, intravascular pressures and thermodilution responses where recorded in the parent artery and aneurysmal dome during injections of room-temperature isotonic sodium chloride solution over 4 seconds (5 mL/s) and 2 seconds (20 mL/s) in the parent artery.
RESULTS: Before GDC coil placement, similar U-shaped thermodilution curves were present in the parent artery and in the dome of the aneurysm. GDC coil placement reduced intraaneurysmal flow by 61-99.6% (P <.05), prolonged aneurysmal filling and washout (dilution interval increased from 5.16 seconds before coil placement to 26.79 seconds after coil placement, P < 0.05), and caused a dissociation of pressure and flow (shift epsilon was 0.45 seconds before coil placement versus 0.56 seconds after coil placement, P <.05). Flow in the parent artery was not significantly affected by GDC coil placement in the aneurysm.
CONCLUSION: In this model, intraaneurysmal blood flow can be evaluated with thermodilution. GDC coil placement significantly reduces blood flow in aneurysms.