MECHANICAL DETACHMENT OF GUGLIELMI DETACHABLE COILS AFTER FAILED ELECTROLYTIC DETACHMENT: RESCUE FROM A TECHNICAL COMPLICATION

Abstract

OBJECTIVE: We describe the mechanical detachment of 2 Guglielmi detachable coils (GDC) that had been placed in a ruptured aneurysm and that failed to detach by electrolysis. METHODS: Mechanical detachment was attempted by continuously rotating the delivery wire. The feasibility and reproducibility of this maneuver was tested by conducting additional in vitro tests. RESULTS: Two GDCs that had been positioned in a ruptured cerebral aneurysm and had failed to detach by electrolysis were separated from the delivery wire by rotating the wire until the weakest segment of the coils broke. GDCs tested in vitro with correct detachment positioning could be separated from the microcatheter tip by approximately 15 rotations of the delivery wire without coil loop movement inside the aneurysm. CONCLUSION: Mechanical detachment of an electrolytic GDC by rotating the delivery wire until a break occurs can be safely performed in a potentially risky situation caused by detachment failure during GDC embolization of cerebral aneurysms. KEY WORDS: Cerebral aneurysm, Coiling, Electrolytic detachable coil, Mechanical detachment