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Case report
Immunohistochemical analysis of a ruptured basilar top aneurysm autopsied 22 years after embolization with Guglielmi detachable coils
  1. Ichiro Yuki1,2,
  2. Daniel Spitzer3,
  3. Guido Guglielmi4,
  4. Gary Duckwiler4,
  5. Motoaki Fujimoto4,
  6. Hiroyuki Takao4,
  7. Reza Jahan4,
  8. Satoshi Tateshima4,
  9. Yuichi Murayama5,
  10. Fernando Vinuela4
  1. 1Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan
  2. 2Department of Radiology, UCLA Medical Center, Los Angeles, USA
  3. 3Department of Neurosurgery, Hudson Valley Neurosurgery, Los Angeles, California, USA
  4. 4Department of Radiological Sciences, UCLA Medical Center, Los Angeles, California, USA
  5. 5Department of Neurosurgery, The Jikei University Hospital, Tokyo, Japan
  1. Correspondence to Dr Ichiro Yuki, Department of Neurosurgery, Jikei University School of Medicine, Nishishinbashi 3-19-18, Minato-ku, Tokyo 105-8471, Japan; ichiroyuki{at}gmail.com

Abstract

The authors report on the histologic and immunohistochemical analyses of a cerebral aneurysm embolized with platinum coils and with the longest observation period. A 58-year-old woman presenting with subarachnoid hemorrhage due to ruptured basilar top aneurysm was treated with Guglielmi detachable coils (GDC) 22 years ago. She was the 15th case since the GDC was introduced. After she died of unrelated causes, an autopsy and thorough histologic examination were performed. Gross examination revealed no adhesion between the aneurysm wall and the surrounding brain tissue. Histologic and immunohistochemical analyses demonstrated that the cavity of the aneurysm was filled with homogeneous collagenous fibrous tissue, while the neck was completely covered by a dense collagenous neointima and a smooth muscle cell layer. The unique histologic results of this case may contribute to a better understanding of the long-term evolution of the healing process in intracranial aneurysms successfully treated with the GDC.

  • Aneurysm
  • Coil
  • Device
  • Intervention
  • History

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