A brain aneurysm is a dangerous thinning and ballooning of an artery wall inside the brain. If an aneurysm ruptures, the resulting bleeding inside the brain can trigger a stroke or coma, as well as loss of life. Endovascular coiling, also known as endovascular embolization, is a modern procedure designed to seal off blood flow to the aneurysm-damaged area inside an artery.
Treatment Considerations
According to the Mayfield Clinic, you may undergo endovascular coiling for either a ruptured or intact aneurysm. If your aneurysm has ruptured, you will first be medically stabilized, and then examined to determine the aneurysm's location. Once the aneurysm is found, your doctors will decide treat it. In some cases, an older, more invasive form of treatment called surgical clipping may be the most suitable method of aneurysm repair. However, if you are 40 or older, are in poor overall health, or have a serious medical condition, endovascular coiling is a viable option. The size and location of your aneurysm will also influence your doctors' decision. If your aneurysm has not yet ruptured, the same basic treatment considerations come into play.
Treatment
Your endovascular coiling procedure will typically take place in a hospital's radiology department. This location gives your doctors access to the imaging equipment needed for treatment. Depending on your condition, the procedure will be performed under either general anesthesia or conscious sedation.
At the start of the procedure you will lie on your back. A trained neurosurgeon will then insert a hollow needle into the femoral artery located in your thigh. Using this needle as a guide, he will insert a thin tube called a catheter into your artery. Once the catheter is inserted, your surgeon will use it to inject a special material called a contrast dye, which will highlight your blood vessels and make them visible on an exterior X-ray monitor. Gradually, he will use the pathway marked out by the contrast dye to pass the catheter up your body through your aorta, past your heart, and up into the brain through one of the four arteries in your neck.
When the catheter is roughly in place, your surgeon will inject more contrast dye and take X-rays of your brain. Using these images, he will guide the catheter to the exact location of your aneurysm. At this point, he will pass a smaller catheter through the interior of the first catheter and directly into the aneurysm. He will then pass a series of small platinum coils through this second catheter and place them individually in the aneurysm's interior. Once the aneurysm is filled with coils, your surgeon will inject more contrast dye and make sure that blood that was once flowing into the aneurysm is now continuing past it. He will also make sure that no coils are obstructing the main path of the artery. Once the coils are properly placed, the catheters will be removed and pressure will be applied to your femoral artery until any bleeding there is under control.
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