ENDOVASCULAR SURGERY — ANEURYSM COILING
(Originally developed by my mentor Dr. Fernando Vinuela from UCLA)
On the main page, please click on Endovascular Surgical Neuroradiology to learn the history of endovascular aneurysm treatment.
As with other endovascular treatments for conditions such as stroke or angioplasty, a catheter is inserted in the groin area and threaded through the vessels to the site of the aneurysm under x-ray guidance. Detachable coils are then dispensed through the catheter and placed carefully inside the aneurysm. The number of coils used depends on the size of the aneurysm.
As an aneurysm is really a “ballooning” in a weakened area of a vessel wall, the goal of “coiling” is to pack the aneurysm tightly to close off blood flow into the aneurysm, thereby preventing its rupture. Occasionally, it is necessary to add more coils at a later time to complete treatment.
Depending on the size and configuration (wide neck vs. small neck) of the aneurysm, more advanced methods of treatment can be used.
Balloon assisted coiling
This procedure involves coiling (as above) in combination with a tiny balloon catheter to aid in holding the coil in place.
Combination of stent and coiling
This procedure involves coiling, as above, in combination with a stent (a small flexible cylindrical mesh tube) that provides a scaffold for the coil mass. This technique is very important for the management of wide neck and fusiform aneurysms.
The hospitalization time varies from patient to patient. A 1-2 day hospitalization may be required for certain patients who have not had a hemorrhage, but patients who have had a recent brain hemorrhage from a ruptured aneurysm may expect to be hospitalized at a minimum between 10-14 days.
A follow-up x-ray, MRI or MRA scan, or an angiogram may be performed to evaluate the position of coils or to assess the healing of the treated aneurysm.
Patients may be placed on a blood thinner such as aspirin or Plavix before and after the procedure, especially when treating more complex wide neck aneurysms.
Open surgery – Aneurysm Clipping
A surgical procedure requiring creation of an opening in the skull through which the surgeon’s instruments can enter. The surgeon can then place a clip across the neck of the aneurysm, preventing arterial blood from entering it. If there is a clot in the aneurysm, the clip also prevents the clot from entering the artery and possibly causing a stroke.
Please click on here to learn about history of endovascular aneurysm treatment.
