Guido Guglielmi

Carotid-cavernous fistula caused by a ruptured intracavernous aneurysm: endovascular treatment by electrothrombosis with detachable coils.

A case of carotid-cavernous fistula caused by a ruptured intracavernous aneurysm is reported. The fistula was treated with electrothrombosis by the detachment of two platinum coils into the aneurysm via an endovascular transvenous approach; the fistula was closed, and the patient has recovered completely. The advantages of using electrodetachable platinum coils include thrombogenicity, controllable deposit, radiopacity, and biocompatibility.

Vertebral hemangiomas with cord compression: The role of embolization in five cases

Five new cases of vertebral hemangioma with cord compression are reported. The role of preoperative selective angiography with embolization in the management of these lesions is discussed in the light of the most important literature on this topic.

Carotid-Cavernous Fistula Caused by a Ruptured Intracavernous Aneurysm

A case of carotid-cavernous fistula caused by a ruptured intracavernous aneurysm is reported. The fistula was treated with electrothrombosis by the detachment of two platinum coils into the aneurysm via an endovascular transvenous approach; the fistula was closed, and the patient has recovered completely. The advantages of using electrodetachable platinum coils include thrombogenicity, controllable deposit, radiopacity, and biocompatibility.

Persistent primitive trigeminal artery-cavernous sinus fistulas: Report of two cases

Two cases of persistent primitive trigeminal artery-cavernous sinus fistulas are presented. In one case, the fistula was treated by using a two-balloon tandem technique. This method was accomplished by introducing, inflating, and detaching a silicone balloon into the trigeminal artery, thus preserving the carotid and basilar blood flow. An unusual case of a similar fistula with only contralateral exophthalmos is also reported. The relationship between this type of fistula and the presence of aneurysms on the persistent primitive trigeminal artery and the relationship with traumatic events are discussed.

Endovascular Treatment of Intracranial Aneurysms with Detachable Coils and Electrothrombosis

The technique of intra-aneurysmal electrothrombosis via an endovascular approach was conceived about a decade ago (Guglielmi et al. 1983), integrating the observations of Sawyer (Sawyer and Pate 1953a,b; Sawyer et al. 1953), Mullan (MuLLAN 1974; Mullan et al. 1964, 1965, 1969), and Piton (Piton et al. 1978). Not until recently, however, has the technology become available to produce microcatheters and microguidewires soft enough to navigate atraumatically into cerebral aneurysms. A novel device, consisting of a soft detachable platinum coil soldered to a stainless steel delivery wire, was developed and tested during animal experimental research performed at U.C.L.A. in 1989 (Guglielmi et al. 1991a). The goal was to find an endovascular occlusive agent that would adopt the shape of intracranial aneurysms without distorting their fragile walls.

Endovascular Treatment of Intracranial Saccular Aneurysms with GDC Platinum Detachable Coils: Small-Necked Aneurysms

The rationale for treatment of small intracranial aneurysms is to avoid bleeding in unruptured ones or to prevent rebleeding in ruptured ones. In an effort to widen the therapeutic management of surgically difficult intracranial aneurysms, an endovascular approach utilizing platinum detachable coils and electrothrombosis has been developed1,2.

Est modus in rebus.

In the July 2013 issue of the American Journal of Neuroradiology an editorial appeared, authored by Dr H.J. Cloft, entitled “Capitalism and Commodities: My Two Cents.”[1][1]nnIn the editorial, Dr Cloft explains that nowadays “more that 20 years after the invention of the Guglielmi Detachable

L'embolizzazione terapeutica in neuroradiologia

Gli Autori espongono la loro esperienza di embolizzazione terapeutica in Neuroradiologia. Vengono presentati alcuni casi esemplificativi.

Electrical Models in the Analysis of Hemodynamic Characteristics of Arteriovenous Malformations Part 1: Baseline Measurements

Sono stati eseguiti 35 esami SPECT con 99mTc-sesta-MIBI su 28 pazienti affetti da tumore cerebrale primitivo maligno e già sottoposti ad intervento chirurgico, radioterapia e chemiotera-pia. Gli esami sono stati confrontati con TC e/o RM per valutarne lutilità nella diagnosi differenziale tra recidiva del tumore e radionecrosi. In mancanza di un sicuro riscontro chirurgico o autoptico, è stato tenuto conto dellevoluzione successiva della lesione alla TC e/o alla RM. Con questo criterio sono risultati 6 casi falsi negativi e 1 caso falso positivo alla SPECT.

Lo studio del canale rachideo con contrasto idrosolubile

Gli autori riferiscono la loro esperienza nella diagnostica delle affezioni del canale spinale mediante introduzione endorachidea di contrasto idrosolubile a bassa concentrazione: 1500 casi. La casistica comprende 1117 spondiloartrosi, 92 ernie lombari, 15 ernie cervicali, 12 ernie dorsali, 30 tumori intramidollari, 12 malformazioni vascolari, 46 malformazioni della cerniera, 35 aracnoiditi, 18 siringomielie ed infine 3 diastematomielie. I progressi tecnologici (TC e RMN) tendono a sostituire in molti casi gli esami con mdc; è augurabile che ciò possa avvenire, in un prossimo futuro, per tutte le patologie. Allo stato attuale occorre ricordare che la mielografia, con la tecnica descritta, non presenta gravi complicazioni e consente in tutti i casi una corretta diagnosi.