Cerebral Aneurysm Coiling
Meet Walter, Tucson grandfather
In August 2012, Walter fainted and fell to the floor. His wife took him to the Emergency Room, where a large brain aneurysm was discovered. Walter’s doctor referred him to the Interventional Neuroradiologists at Radiology Ltd. in Tucson, who performed an aneurysm coiling procedure in which they fed flexible platinum hair-thin coils through the body and into the brain aneurysm, effectively sealing it off so it won’t rupture in the future. No bleeding, a tiny scar, and no long hospital stay. Now Walter and his wife are back to traveling and enjoying their retirement!
A cerebral aneurysm is a weak spot on one of the arteries of the brain that balloons out and has the potential to rupture. Cerebral aneurysms are most frequently detected between the ages of 35 and 60 and are more common in women than men. They may be detected prior to rupturing with imaging studies such as MR angiography (MRA), CT angiography (CTA), or conventional cerebral angiography.
A ruptured brain aneurysm is a medical emergency and causes bleeding into the fluid surrounding the brain (called the subarachnoid space). Half of patients die within thirty days of rupture, and of those patients that survive, half suffer from significant neurological impairment. Once an aneurysm ruptures, it is almost always treated emergently. However, if an aneurysm is detected prior to rupturing, it may be treated electively with surgery or coiling, though some aneurysms are left untreated. Treatment decisions should be made after discussions with specialists including an Interventional Neuroradiologist and a Neurosurgeon.
Surgery is performed by a Neurosurgeon and involves removing a piece of bone from the skull, spreading apart the brain to expose the aneurysm, and placing a metal clip across the neck of the aneurysm before replacing the bone. Coiling is a less invasive method of treating cerebral aneurysms and is performed by an Interventional Neuroradiologist. A catheter (small plastic tube) is placed in the femoral artery located in the groin region and is advanced to the aneurysm using X-ray guidance (fluoroscopy). Once in the aneurysm, small coils made of platinum are threaded through the catheter and are placed into the aneurysm. This prevents blood flow from entering the aneurysm and protects it from rupturing in the future.
Prior to your procedure, you will have a thorough consultation with our Neuroradiology Nurse Case Manager and one of our Interventional Neuroradiologists. All possible treatment options will be reviewed and discussed with you in detail, and all of your questions will be answered. If endovascular coiling is the treatment of choice for you, Radiology Ltd. will make the necessary arrangements for you.
After registering at the hospital, you will be sent to the Special Procedures Area, where you will have an intravenous (IV) line placed in your arm and a tube (Foley catheter) placed into your bladder. Fluids and pain medication will be given prior to your procedure. You will then be sent to the Interventional Suite in the Department of Radiology, where you will meet with your doctor (Interventional Neuroradiologist) and the nurses and technologists trained in this procedure. You will undergo general anesthesia and will be asleep throughout the procedure.
A catheter (or plastic tube) will be advanced into the femoral artery located in your groin region and then advanced into the arteries leading to your brain. An angiogram will then be performed, in which images of the blood vessels are obtained during an injection of iodine-based contrast material. Once the aneurysm is well visualized, coiling of the aneurysm will be performed. At the end of the procedure, the catheter will be removed. You will usually be observed in the hospital overnight. Most patients go home the next day and can return to normal activity within a couple of days.
Significant complications related to aneurysm coiling are uncommon. The primary risks associated with this procedure include:
- Groin hematoma or bruising
- Allergic reaction to the contrast material
For your safety and the protection of others, we do not allow anybody except patients in our exam rooms.
Your procedure will be performed by Dr. Ashdown, Dr. Gyorke, Dr. Jeck, or Dr. Rucker, all of whom are Senior Members of the American Society of Interventional and Therapeutic Neuroradiology (ASITN). They are trained in all aspects of neuroembolizations and are very experienced, with one of the most successful Interventional Neuroradiology practices in the country. For more information or clinical questions, please call Faith Johnston at (520) 901-6616. To schedule a consultation, please call Tracey Bassett at (520) 873-3724.