What Is Brain Aneurism Coiling?

What is a brain aneurysm coiling procedure?

Endovascular coiling, a brain aneurysm coiling procedure, is a minimally invasive treatment used to treat an intracranial aneurysm, which is a weakened area in the wall of a blood vessel in the brain that can bulge or balloon out.

Here’s how the procedure works:

• Preparation: The patient is typically given sedation or general anesthesia. A catheter is then inserted into a blood vessel, usually in the groin area.
• Accessing the aneurysm: The catheter is carefully guided through the blood vessels to the location of the aneurysm in the brain. This is done using real-time imaging techniques such as fluoroscopy.
• Coiling the aneurysm: Once the catheter reaches the aneurysm, small platinum coils are placed inside the aneurysm sac. These coils help encourage the formation of a blood clot within the aneurysm, effectively sealing it off from normal blood flow.
• Result: By blocking the aneurysm, the procedure reduces the risk of rupture and subsequent bleeding, which can lead to severe complications like stroke.

Types of brain aneurysm coiling procedures

There are a few different types of coiling used for treating aneurysms:

• Conventional coiling: This method is used for smaller or more easily accessible aneurysms that have a narrow neck. It involves filling the aneurysm with platinum coils to encourage clot formation and seal it off.
• Stent-assisted coiling: This technique is used for larger or wide-necked aneurysms. It involves placing a stent in the parent artery to provide support while inserting the coils.
• Balloon-assisted coiling: This approach is used for more complex cases, particularly those with wide-necked aneurysms. It involves inflating a balloon in the parent vessel to support the placement of the coils.

What is the success rate for brain aneurysm coiling?

A 2014 study examined the success rates of coiling treatment for large and giant brain aneurysms (10 mm or larger), analyzing data from 334 patients between 2004 and 2011.

The researchers found that complications occurred in about 10.5% of patients, with only one reported death.

Overall, 92% of patients experienced favorable outcomes after the procedure. However, the study found that aneurysms often reopened, with recanalization rates reaching 39% and retreatment rates at 33%.

When aneurysms reopen, they carry a risk of growing larger or rupturing, which can lead to serious complications such as hemorrhagic stroke or other neurological issues.

Larger aneurysms and certain locations were associated with higher rates of reopening and complications. Notably, stent-assisted coiling yielded better results in minimizing these issues compared to conventional coiling.

A 2022 study focused on the effectiveness of endovascular treatments, specifically coiling and balloon-assisted coiling, involving 1,289 patients with 945 aneurysms treated in 908 of them.

The results revealed that 29.5% of aneurysms had recanalization. The recanalization rates were similar for both treatment methods, at 28.9% for coiling and 30.3% for balloon-assisted coiling.

Several factors were linked to a higher likelihood of recanalization:

• smoking
• having a ruptured aneurysm
• having an aneurysm that’s 10 mm or larger
• having a wide-neck aneurysm
• having an aneurysm that’s located in the middle cerebral artery

Side effects and complications of brain aneurysm coiling

The coiling procedure for treating brain aneurysms, while generally considered safe, can still carry potential side effects and complications.

Here are some of the common ones:

• Headache: Some may experience headache after the procedure. Headaches can vary in intensity.
• Nausea: Some individuals may feel nauseous post-operation, often related to anesthesia or pain.
• Fatigue: It’s typical to feel tired following the procedure as the body recovers.

Here are the potential complications:

• Rebleeding: The aneurysm may reopen or bleed again after treatment, which can be life threatening.
• Aneurysmal perforations: This occurs when the microcatheter, guidewire, or coil accidentally punctures the aneurysm, which can lead to bleeding.
• Thromboembolic events: These involve the formation of blood clots that can block blood vessels, potentially causing serious complications.
• Infection: There is a risk of infection at the site where the catheter is inserted or in the bloodstream, which can complicate recovery.
• Neurological deficits: Damage to brain tissue during the procedure may result in temporary or permanent neurological problems, such as weakness, speech difficulties, or coordination issues.
• Allergic reactions: Some patients may have allergic reactions to the contrast dye used during imaging, leading to symptoms like itching, rash, or more severe reactions.
• Vascular complications: Injury to blood vessels can occur during the procedure, which may cause additional problems such as bleeding or reduced blood flow.
• Hypoxia: Reduced oxygen supply to the brain during the procedure can potentially lead to complications.

Recovery timeline for brain aneurysm coiling

Your recovery timeline for brain aneurysm coiling can vary, but here’s a general overview:

• 1 to 2 days: You will be monitored in the hospital.
• 1 to 3 days: If there are no complications, you can go home.
• 1 to 3 weeks: You might experience fatigue and mild headaches; you can start to resume light activities.
• 1 to 6 weeks: A follow-up imaging appointment will be scheduled to check the aneurysm.
• Weeks to months: Your full recovery may take several months.

Takeaway

Brain aneurysm coiling is a promising and effective treatment that significantly reduces the risk of rupture, offering hope for many individuals.

While it’s important to be aware of potential complications and the recovery process, the procedure’s minimally invasive nature and positive outcomes can offer a promising future to those with the condition.

By staying informed and working closely with your healthcare team, you can take proactive steps toward a successful recovery and improved quality of life.