{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:29:08Z","timestamp":1780637348054,"version":"3.54.1"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,6]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> Embolization of intracranial aneurysms performed using Guglielmi detachable coils (GDCs) is performed with the patient in a state of general anesthesia at most centers. Such an approach does not allow intraprocedural evaluation of the patient's neurological status and carries additional risks associated with general anesthesia and mechanical ventilation. At the authors' institution, GDC embolization of intracranial aneurysms is performed in awake patients after administration of sedative and analgesic agents (midazolam, fentanyl, morphine, and\/or hydromorphone). To determine the feasibility and safety of this approach, the authors have retrospectively reviewed their clinical experience.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> The authors reviewed the medical records of all patients in whom GDC embolization for the treatment of intracranial aneurysms was undertaken between February 1, 1990 and October 31, 1999. Clinical presentation, medical comorbidities, anesthetic agents used, intraprocedural complications, and final procedural outcome were recorded for each patient.<\/jats:p>\n<jats:p content-type=\"fine-print\">Guglielmi detachable coil embolization was attempted in the awake patient in 150 procedures. Among 92 procedures for unruptured aneurysms, 75 (82%) were completed without complications. Four procedures were completed with complications. Of the 92 procedures, 13 were aborted due to patient uncooperativeness (one patient), complications (three patients), morphological characteristics of the aneurysm or surrounding vessels that made embolization technically difficult (eight patients), or vasospasm (one patient). Among 58 procedures for ruptured aneurysms, the procedure was completed without complication in 48 cases (83%). The procedure was completed with complications in five cases and two patients required induction of general anesthesia during the procedure. Five procedures were aborted because morphological characteristics of the aneurysm or surrounding vessels made embolization technically difficult (two patients) or because of aneurysm rupture (two patients) or the appearance of a transient neurological deficit (one patient).<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Embolization of intracranial aneurysms performed using GDCs in the awake patient appears to be safe and feasible and allows intraprocedural evaluation of the patient. Potential advantages, including decreased cardiopulmonary morbidity rates, shorter hospital stay, and lower hospital costs, still require confirmation by a direct comparison with other anesthetic procedures.<\/jats:p>","DOI":"10.3171\/jns.2001.94.6.0880","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:34:58Z","timestamp":1242236098000},"page":"880-885","source":"Crossref","is-referenced-by-count":81,"title":["Endovascular treatment of intracranial aneurysms by using Guglielmi detachable coils in awake patients: safety and feasibility"],"prefix":"10.3171","volume":"94","author":[{"given":"Adnan I.","family":"Qureshi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Fareed K.","family":"Suri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jehanzeb","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley H.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard D.","family":"Fessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Ringer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee R.","family":"Guterman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Nelson","family":"Hopkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Vasc Surg","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1016\/S0741-5214(94)70008-7","article-title":"The influence of anesthetic technique on perioperative complications after carotid endarterectomy.","volume":"19","author":"Allen","year":"1994"},{"key":"b2","series-title":"J Vasc Surg","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/S0741-5214(97)70038-7","article-title":"Improving the cost-effectiveness of carotid endarterectomy.","volume":"26","author":"Back","year":"1997"},{"key":"b3","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3171\/jns.1993.79.1.0003","article-title":"Selective endovascular treatment of 71 intracranial aneurysms with platinum coils.","volume":"79","author":"Casasco","year":"1993"},{"key":"b4","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1148\/radiology.206.2.9457205","article-title":"Intracranial berry aneurysms: angiographic and clinical results after endovascular treatment.","volume":"206","author":"Cognard","year":"1998"},{"key":"b5","series-title":"J Vasc Surg","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1016\/0741-5214(92)90056-E","article-title":"Carotid endarterectomy: a safe cost-efficient approach.","volume":"16","author":"Collier","year":"1992"},{"key":"b6","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"81","DOI":"10.3171\/jns.1998.89.1.0081","article-title":"Endovascular embolization of 150 basilar tip aneurysms with Guglielmi detachable coils: results of the Food and Drug Administration multicenter clinical trial.","volume":"89","author":"Eskridge","year":"1998"},{"key":"b7","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1097\/00000542-199002000-00009","article-title":"Multicenter study of general anesthesia. II. Results.","volume":"72","author":"Forrest","year":"1990"},{"key":"b8","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/00000542-199201000-00002","article-title":"Multicenter study of general anesthesia. III. Predictors of severe perioperative adverse outcomes.","volume":"76","author":"Forrest","year":"1992"},{"key":"b9","series-title":"Ann Vasc Surg","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1007\/s100169900227","article-title":"Postoperative blood pressure changes associated with cervical block versus general anesthesia following carotid endarterectomy.","volume":"13","author":"Hartsell","year":"1999"},{"key":"b10","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1097\/00006123-199811000-00007","article-title":"Clinical and angiographic outcomes, with treatment data, for patients with cerebral aneurysms treated with Guglielmi detachable coils: a single-center experience.","volume":"43","author":"Kuether","year":"1998"},{"key":"b11","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1161\/01.STR.31.1.100","article-title":"Endovascular treatment of ruptured posterior circulation cerebral aneurysms. Clinical and angiographic outcomes.","volume":"31","author":"Lempert","year":"2000"},{"key":"b12","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"176","DOI":"10.3171\/jns.1997.87.2.0176","article-title":"Intracranial aneurysms treated with the Guglielmi detachable coil: midterm clinical results in a consecutive series of 100 patients.","volume":"87","author":"Malisch","year":"1997"},{"key":"b13","series-title":"J Clin Anesth","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1016\/0952-8180(95)00157-3","article-title":"Recovery advantages of regional anesthesia compared with general anesthesia: adult patients.","volume":"7","author":"Mingus","year":"1995"},{"key":"b14","series-title":"Am J Surg","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/S0002-9610(97)89615-8","article-title":"Effect of anesthetic technique on cardiac morbidity following carotid artery surgery.","volume":"171","author":"Ombrellaro","year":"1996"},{"key":"b15","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1097\/00006123-199807000-00013","article-title":"Risk factors for multiple intracranial aneurysms.","volume":"43","author":"Qureshi","year":"1998"},{"key":"b16","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1093\/neurosurgery\/46.1.44","article-title":"Factors associated with aneurysm size in patients with subarachnoid hemorrhage: effect of smoking and aneurysm location.","volume":"46","author":"Qureshi","year":"2000"},{"key":"b17","series-title":"J Vasc Surg","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/S0741-5214(99)70185-0","article-title":"Locoregional versus general anesthesia in carotid surgery: is there an impact on perioperative myocardial ischemia? Results of a prospective monocentric randomized trial.","volume":"30","author":"Sbarigia","year":"1999"},{"key":"b18","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"857","DOI":"10.3171\/jns.1999.90.5.0857","article-title":"Endovascular treatment of multiple intracranial aneurysms by using Guglielmi detachable coils.","volume":"90","author":"Solander","year":"1999"},{"key":"b19","series-title":"Eur J Vasc Endovasc Surg","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/S1078-5884(97)80178-5","article-title":"Local versus general anaesthesia for carotid endarterectomy: a systemic review of the evidence.","volume":"13","author":"Tangkanakul","year":"1997"},{"key":"b20","series-title":"Lancet","first-page":"81","article-title":"Assessment of coma and impaired consciousness. A practical scale.","volume":"2","author":"Teasdale","year":"1974"},{"key":"b21","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1148\/radiology.211.2.r99ap06325","article-title":"Ruptured intracranial aneurysms: acute endovascular treatment with electrolytically detachable coils\u2014a prospective randomized study.","volume":"211","author":"Vanninen","year":"1999"},{"key":"b22","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"475","DOI":"10.3171\/jns.1997.86.3.0475","article-title":"Guglielmi detachable coil embolization of acute intracranial aneurysm: perioperative anatomical and clinical outcome in 403 patients.","volume":"86","author":"Vi\u00f1uela","year":"1997"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/94\/6\/article-p880.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/94\/6\/article-p880.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/94\/6\/article-p880.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:07:07Z","timestamp":1679875627000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/94\/6\/article-p880.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,6]]},"references-count":22,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/jns.2001.94.6.0880","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[2001,6]]}}}