Extracranial aneurysm and arteriovenous fistula: embolization with the Guglielmi detachable coil.

PURPOSE To evaluate the feasibility and safety of Guglielmi detachable coils for endovascular treatment of extracranial aneurysm and arteriovenous fistula. MATERIALS AND METHODS Embolization with Guglielmi detachable coils delivered through Tracker-18 microcatheters was performed in 16 patients. This patient group had eight renal artery aneurysms and 11 arteriovenous fistulas (three cases of patent ductus arteriosus, one associated with aneurysm; one fistula between the maxillary artery and jugular vein; two fistulas between the subclavian and pulmonary arteries; four fistulas between the pulmonary artery and vein; and one fistula between the anterior tibial artery and vein). Efficacy of the procedure was assessed by means of short-term follow-up (clinical examination, angiography, and/or Doppler sonography) 3 and 6 months later. RESULTS No complications were encountered. Embolization was technically and clinically successfully in all eight aneurysms (100%) and in nine arteriovenous fistulas (82%). In two cases (fistula between the subclavian and pulmonary arteries and fistula between the anterior tibial artery and vein) endovascular placement of Guglielmi detachable coils failed to occlude the vessel. Results of short-term follow-up examinations confirmed the initial results in all cases. CONCLUSION Guglielmi detachable coils are feasible, safe, and effective for endovascular treatment of extracranial aneurysm and arteriovenous fistula.