Intra-aneurysmal GDC embolization for ruptured aneurysm in the acute stage.

: This study focused on our experiences in intraaneurysmal embolization for ruptured aneurysm in the acute stage. Clinical materials of this study consist of 37 patients who were treated with intra-aneurysmal GDC embolization within 72 hours after the onset of subarachnoid hemorrhage from December 1995 to July 1998. Patients with cerebral aneurysms are always examined as possible candidates for neurosurgical clipping. If the patient had any difficulties and/or problems on neurosurgical clipping (high age 22, poor grade 15, surgically difficult location 9, systemic disease 3), the patient was treated by intra-aneurysmal GDC embolization. GDCs were inserted as tight as possible. Then, spinal drainage was set in patients with thick subarachnoid hemorrhage. Tissue plasminogen activator was administered via the drainage in patients with thicker subarachnoid hemorrhage. One patient experienced rerupture during peritherapeutic period. Symptomatic vasospasm was observed in three patients (8.1%). Good outcome was obtained in 26 out of 30 surviving patients. Symptomatic complication caused by distal embolism occurred in two patients. In conclusion, intra-aneurysmal GDC embolization is thought to be sufficient regarding prevention of rerupture, incidence of vasospasm, and clinical outcome.