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OtherINTERVENTIONAL

Histopathologic Findings in Human Cerebral Aneurysms Embolized with Platinum Coils: Report of Two Cases and Review of the Literature

Shoichiro Ishihara, Michel E. Mawad, Kentaro Ogata, Chihiro Suzuki, Nobusuke Tsuzuki, Hiroshi Katoh, Akira Ohnuki, Takahito Miyazawa, Hiroshi Nawashiro, Tatsumi Kaji and Katsuji Shima
American Journal of Neuroradiology June 2002, 23 (6) 970-974;
Shoichiro Ishihara
aDepartment of Neurosurgery, National Defense Medical College, Tokorozawa, Japan
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Michel E. Mawad
eDepartment of Neuroradiology, The Methodist Hospital, Baylor College of Medicine, Houston, TX
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Kentaro Ogata
cDepartment of Pathology, National Defense Medical College, Tokorozawa, Japan
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Chihiro Suzuki
dDepartment of Neurosurgery, Musashino General Hospital, Kawagoe, Japan
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Nobusuke Tsuzuki
aDepartment of Neurosurgery, National Defense Medical College, Tokorozawa, Japan
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Hiroshi Katoh
aDepartment of Neurosurgery, National Defense Medical College, Tokorozawa, Japan
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Akira Ohnuki
aDepartment of Neurosurgery, National Defense Medical College, Tokorozawa, Japan
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Takahito Miyazawa
aDepartment of Neurosurgery, National Defense Medical College, Tokorozawa, Japan
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Hiroshi Nawashiro
aDepartment of Neurosurgery, National Defense Medical College, Tokorozawa, Japan
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Tatsumi Kaji
bDepartment of Radiology, National Defense Medical College, Tokorozawa, Japan
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Katsuji Shima
aDepartment of Neurosurgery, National Defense Medical College, Tokorozawa, Japan
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    Fig 1.

    Images from the case of a 65-year-old man with an unruptured aneurysm (case 1).

    A, Pretreatment cerebral angiogram shows the 5-mm anterior communicating artery aneurysm.

    B, Post-treatment cerebral angiogram shows embolization by interlocking detachable coils (4 mm × 8 cm and 3 mm × 6 cm).

  • Fig 2.
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    Fig 2.

    Gross pathologic findings in case 1.

    A, Gross outlook appearance of the thin wall of the aneurysm through which embedded coils are seen.

    B, Intraluminal view shows a thin transparent layer of membrane covering the whole orifice of the aneurysm and bridged over the underlying coils.

    C, Scanning electron microscopy shows that the coils are covered by thick neointima at the orifice of the aneurysm. Part of the neointima was removed for transmission electron microscopic study (original magnification, ×50; bar = 100 μm).

    D, Superficial layer of neointima with a cobblestone appearance (original magnification, ×1000; bar = 10 μm).

  • Fig 3.
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    Fig 3.

    Transmission electron microscopy and light microscopy (case 1).

    A, Basal lamina runs contiguously along the basal endothelial cytoplasmic membrane (original magnification, ×2000; bar = 2 μm).

    B, Light microscopy shows cotton-like white fibrous tissue in the dome of the aneurysm (hematoxylin and eosin stain; original magnification, ×74).

  • Fig 4.
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    Fig 4.

    Images from the case of a 62-year-old man with subarachnoid hemorrhage (case 2).

    A, Right pre-embolization vertebral angiography shows 4-mm left basilar artery-superior cerebellar artery aneurysm.

    B, After embolization by GDC (3 mm × 4 cm and 2 mm × 4 cm), almost total obliteration was achieved.

    C, Gross examination shows thin membrane on coils at orifice of aneurysm. The thin fragile covering bridges the whole space across the coils at the orifice.

    D, Scanning electron microscopy shows neointima partially covering the coils (GDC-10 soft). A cobblestone pattern can be seen (original magnification, ×370; bar = 100 μm).

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American Journal of Neuroradiology: 23 (6)
American Journal of Neuroradiology
Vol. 23, Issue 6
1 Jun 2002
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Shoichiro Ishihara, Michel E. Mawad, Kentaro Ogata, Chihiro Suzuki, Nobusuke Tsuzuki, Hiroshi Katoh, Akira Ohnuki, Takahito Miyazawa, Hiroshi Nawashiro, Tatsumi Kaji, Katsuji Shima
Histopathologic Findings in Human Cerebral Aneurysms Embolized with Platinum Coils: Report of Two Cases and Review of the Literature
American Journal of Neuroradiology Jun 2002, 23 (6) 970-974;

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Histopathologic Findings in Human Cerebral Aneurysms Embolized with Platinum Coils: Report of Two Cases and Review of the Literature
Shoichiro Ishihara, Michel E. Mawad, Kentaro Ogata, Chihiro Suzuki, Nobusuke Tsuzuki, Hiroshi Katoh, Akira Ohnuki, Takahito Miyazawa, Hiroshi Nawashiro, Tatsumi Kaji, Katsuji Shima
American Journal of Neuroradiology Jun 2002, 23 (6) 970-974;
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