Pitfalls of GDC Embolisation of Intracranial Aneurysms.

SUMMARY: We present a critical analysis of the cerebral aneurysm GDC embolisation technique and its numerous possible pitfalls with the experience of 448 aneurysms in 401 patients performed during a seven year period at UCLA's Division of Interventional Neuroradiology. A "pitfall" is defined as any hidden or not easily recognized danger or difficulty. We review pitfalls related to micro-catheterization, GDC coil delivery, complex vascular anatomy, post-embolisation management, and pre-existing patient's clinical condition. The possible associated technical and clinical complications include aneurysm rupture, parent artery occlusion, thrombo-embolic stroke, coil stretching/rupture, coil migration, incomplete embolisation or embolisation failure. Lastly we present a discussion of our experience and suggestions of how to avoid some of these pitfalls.