Guglielmi detachable coil: report of intraoperative complications

The newest therapy for cerebral aneurysm is the Guglielmi detachable coil (GDC). The authors describe the anesthetic management of two patients with intraoperative subarachnoid hemorrhage during Guglielmi coil placement. Various treatments for intraoperative hemorrhage are discussed, as are other common complications that can occur during placement of intravascular, intracranial coils. The placement of a ventriculostomy was a major contributing factor in the good outcome of both patients. Consideration should be given to placement of a ventriculostomy before the GDC procedure. Although the GDC procedure offers much promise, it is not a benign procedure and has its own set of complications that will no doubt challenge the neuroanesthesiologist.