The Guglielmi coil for transarterial occlusion of intracranial aneurysm: preliminary Western Australian experience.

18 patients aged 3-75 years with cranial arterial aneuryms have been treated by transarterial insertion of Guglielmi Detachable Coils (GDC). 11 patients had previously bled and 9 pts had previous craniotomy for the same aneurysm. 22 technically successful procedures were performed in 17 aneurysms (16 patients). Subsequent repacking was performed 8 times (5 patients). There were 4 unsuccessful procedures in 2 patients. Including repackings, 9 aneurysms (8 patients) show complete occlusion and 7 aneurysms are considered stable with either a neck remnant or persistent partial filling of the aneurysm. 1 aneurysm showed repeated recanalisation necessitating multiple repackings. 1 patient developed recanalisation, aneurysm enlargement and died of recurrent subarachnoid haemorrhage (SAH) at 7 months. 8 patients suffered procedural complications or deficits. 3 patients showed occlusion of a parent artery. On 6-18 month follow up 13 survivors are well and symptom free and 1 has recovered mild hemiparesis. Three recent patients are progressing well but await follow up. Our results are compared with a larger series reported from the North American GDC trial.