Neurointerventional Radiology for Aneurysm Coiling
Leading-edge therapy for minimally invasive treatment of cerebral aneurysm and other cerebrovascular disorders
Darryn Shaff, M.D.
Neurointerventional radiologist More >>
Mark Li, M.D., Ph.D.
Chief, Department of Neurological Surgery More >>
John Castaldo, M.D.
Chief, Department of Neurology More >>
- How do physicians at Lehigh Valley Hospital and Health Network approach aneurysm patients?
- How do specialists evaluate cerebral aneurysms?
- How do specialists treat cerebral aneurysms?
- How does the coiling procedure work?
Q: How do physicians at Lehigh Valley Hospital and Health Network approach aneurysm patients?
We believe a multidisciplinary team of neurosurgeons, neurologists and neuroradiologists is best for patients with aneurysms. More than 30,000 people nationwide suffer from ruptured cerebral aneurysm annually; 10 to 15 percent of them die before reaching a hospital. Without treatment, more than half will die within the first month after an initial rupture. Nearly half of the survivors will suffer permanent brain damage from bleeding at the time of rupture. Our team of experts works together to analyze each patient’s case and determine which course of treatment will produce the best long-term outcome. We have used this approach for three years. The physicians report improved outcomes and decreased surgical complications.
Q: How do specialists evaluate cerebral aneurysms?
Before receiving treatment, a patient with a cerebral aneurysm undergoes an extensive evaluation by a team of neurologists, neurosurgeons and neuroradiologists. The evaluation usually includes:
- Complete physical examination
- Heart function tests
- Tests for specific neurological, motor and sensory deficits
- Diagnostic workup, including an angiogram to provide an image of the brain’s blood flow
- Ultrasound and magnetic resonance imaging (MRI) scans to provide images of the brain’s arteries
In addition, physicians may use a stethoscope to hear changes in blood flow in the carotid arteries. Once the evaluation is complete, the team will recommend a treatment option that best suits the patient’s unique needs.
Q: How do specialists treat cerebral aneurysms?
We treat about 100 aneurysms annually and offer both nonsurgical and surgical treatment. Treatment depends on the size, shape and location of the aneurysm and the patient’s age.
Treatments include:
- Coiling – a neuroendovascular treatment in which tiny coiled wires are fed into an aneurysm to help the blood clot
- Stenting and coiling – in the case of broad-based aneurysms, a stent is first placed across the aneurysm neck to serve as a scaffold for the coils (called stent-assisted coiling).
- Clipping – a surgical procedure in which a tiny metal clip is fastened to the base of an aneurysm to keep blood from flowing into it
Q: How does the coiling procedure work?
Aneurysm coiling is a minimally invasive procedure that treats the aneurysm from inside the blood vessel. The surgeon inserts a catheter into a blood vessel in the groin, then up to the aneurysm site. Once the catheter’s tip reaches the aneurysm, the surgeon threads a very thin platinum wire into the aneurysm through the catheter. The wire coils up as it enters the aneurysm and is then detached. This is repeated until enough coil fills the aneurysm, preventing blood from entering and eliminating the risk for rupture. There are no large incisions, less pain, shorter recovery time, fewer risks and decreased hospital charges than in traditional surgery.
This page last updated 5/6/08 01:53 PM
