Endovascular coiling; Brain aneurysm treatment

Endovascular coiling - treatment of brain aneurysms

Endovascular coiling to treat brain aneurysms is one of the latest methods in this field. Turkey has been interested in developing this surgery due to its many complications and the seriousness of aneurysms.

Endovascular coiling is a new technique that treats aneurysms prophylactically for non-bleeding aneurysms or curatively after bleeding has occurred without opening the skull with X-ray guidance, which reduces complications compared to other procedures, and is a minimally invasive method suitable for those who cannot perform surgery.

The Brain aneurysm treatment (Treatment of aneurysms) is an important and urgent matter because it is a life-threatening condition if the aneurysm wall is perforated. Is intravascular coiling a final solution to this problem? and what are the Symptoms of aneurysm in the head? Follow us in this article.

What is endovascular coiling used to treat brain aneurysms?

Aneurysm (known as cerebral aneurysms) is a weak area in the wall of the artery that leads to the formation of a balloon or cyst in the vessel. The wall of the cyst is thinner than the rest of the artery walls and is at risk of bleeding after exceeding a certain size. Cerebral hemorrhage is an emergency condition that can be fatal.
This type of aneurysm is known as a thymic aneurysm or cystic aneurysm, depending on the way it presents if cerebral aneurysms rupture, causing bleeding in the brain.
An image showing aneurysm and bulge in the brain
Brain aneurysm

Other types of aneurysms include collateral aneurysms; Where a bulge appears along one of the walls of the artery, or a fusiform aneurysm; It is when an entire artery swells.

The exact reason behind the formation of aneurysms is not known, the causes can be genetic (inherited in families) or occur to the pregnant woman due to a defect during pregnancy.

Certain diseases can lead to weakening of the arterial walls and the formation of aneurysms. These include polycystic kidney disease, certain connective tissue disorders, or abnormalities of the blood vessels.

Injury, high blood pressure, or drug use may also increase your risk of developing aneurysms. In rare cases, infection within the artery wall can cause aneurysms to form.

Endovascular coiling

Endovascular coiling is a treatment method for aneurysms without opening the skull or brain surgery.

The coil (or coil) means a thin and delicate wire that is collected inside the aneurysm. The IUD prevents blood flow to the aneurysm by forming a blood clot that helps block it, while the rest of the artery remains open to transfer blood to the brain.

The wire is inserted through a catheter through the large arteries in the body into the arteries of the brain. This treatment is performed as an alternative to aneurysm clipping (surgically isolating the aneurysm by placing a clip at its base to prevent blood from entering it), which requires brain surgery and opening the skull to isolate the mother. the blood.

Symptoms of ruptured brain aneurysms

We will mention the symptoms of aneurysm rupture, because aneurysms in the brain without rupture are mostly asymptomatic unless they reach large sizes.

Symptoms of a ruptured aneurysm include:

  • Sudden, severe headache
  • Epileptic seizures
  • speech disorder
  • Muscle weakness related to the location of the aneurysm
  • Confusion or changes in perception
  • vision changes
  • Permanent brain damage may occur

Who needs endovascular coiling?

Many patients can undergo endovascular coiling. This procedure can be performed whether the aneurysms are intact or ruptured.

Younger patients and elderly individuals may be good candidates. The final determination of whether a patient can undergo angioplasty or requires open surgery depends on the size and shape of the aneurysms.
After diagnosing the presence, shape, and location of the aneurysm, and the patient's age and associated illnesses, health care providers can choose this procedure over open surgery for patients who may not be healthy enough to have major brain surgery.

You can also read about it on our website Hydrocephalus and its treatment in Turkey.

What happens during the endovascular coiling procedure?

Patients are admitted to the hospital on the day of the operation. Patients are not allowed to eat or drink on the day of the operation. An intravenous catheter is opened for the patient to supply fluids.
At the time of the procedure, the patient is transferred to a special room in the radiology department; Where anesthesia or sedation is used to help the patient relax.

A catheter, or long tube, is inserted from the groin into the femoral artery and carefully inserted through the aorta (the aorta, the body's main artery). The catheter is guided through an X-ray to one of the arteries entering the brain.

A contrast dye will be injected to accurately locate the aneurysm by X-ray imaging and the capillaries and blood vessels around them. Small wires are inserted through the catheter (usually made of platinum) and coiled into the aneurysm. Additional wires are implanted in this way until the aneurysm is full.

After the wires are completely inserted and the artery is examined and the aneurysm is closed with the coil, the artery is checked to make sure there is no injury, the catheter is removed.

The area where the catheter was inserted into the femoral artery is tightly pressed for several minutes to prevent bleeding, and then a dressing is placed.

After the procedure is completed, patients are monitored for several hours.
After the procedure, patients may be allowed to go home the same day, however, if the procedure is performed to treat bleeding aneurysms, patients may be hospitalized for several days or weeks.

There are usually some restrictions on activity for several days after the endovascular coil procedure, including no driving or working and some weight lifting restrictions. Patients need to follow up about a month after the procedure to make sure there are no complications.

Endovascular coiling
Endovascular coiling is a minimally invasive procedure that reduces recovery time and the risks of open surgery

Endovascular coiling versus surgical shearing

Surgical techniques have changed over the years; Surgeons are now making very small incisions to access the aneurysm, which reduces disability and length of recovery compared to surgical cuts that require opening the skull to access the aneurysm.

Evaluation of the data collected for both types of procedures indicates that patients undergoing angioplasty have shorter hospital stays, fewer complications, and faster recovery times.

What is the recovery time after endovascular coiling?

Recovery times vary for each patient depending on the patient's general condition, the location of the aneurysm, and whether it has ruptured.

For patients with unruptured aneurysms who undergo endovascular coils, recovery times may be as short as a month.

In the event of a ruptured aneurysm, recovery may take weeks to months; Depending on the amount of bleeding, the extent of damage to nearby tissues, and also the area of the brain in which the aneurysm is located.

Complications of angioplasty

There are some potential risks associated with aneurysms. These can include infection or damage to the artery or aneurysm being treated; In rare cases, the aneurysm can rupture.

An image showing aneurysms and their ruptures in some cases
ruptured aneurysms

A blood vessel spasm, or a sudden narrowing of an artery, can result in reduced blood flow to the brain that is fed by that artery.

A blood clot can form on the catheter or coil as it is injected or in the artery where the catheter is fed. If this happens, the clot can cause a blockage of blood flow or a stroke.

The coils may not stay in place or may not completely block the aneurysm; If this happens, the aneurysm may get larger and larger, and patients may have an allergic reaction to the dye used during the procedure. With any procedure, there is a risk of infection.

In the end, we find that the process of endovascular coiling to treat aneurysms inside the brain is a safe process, with fewer complications and a faster recovery time than other operations. That is why Turkey has adopted this procedure and applied it in most of its hospitals recently.


  1. UT Medical center
  2. University of Rochester Medical Center
  3. UW Medical Center

Frequently Asked Questions

A non-ruptured aneurysm is often asymptomatic, but because the skull is a closed, non-expandable box, aneurysms may cause an increase in intracranial pressure, causing vision problems, sometimes movement disturbances, and pain behind the eye.
If the aneurysm ruptures, sudden symptoms such as severe headache, vomiting, nausea, sensitivity to light and sometimes loss of consciousness appear.

This operation is performed under local anesthesia.

according to A study that followed patients for a long time after endovascular coiling. The annual bleeding incidence rate for a patient treated with this method was as low as 0.1%. If the aneurysms were bleeding before, the annual recurrence rate is about 1.3%

Specific costs for angioplasty are not available. Many factors play a role in determining the cost of the procedure, including whether the aneurysms have already ruptured, the age of the patient, the presence of associated diseases, whether hospitalization is needed after the process, and the number of aneurysms treated>

If you are planning for treatment in Turkey
you can talk to us here.

If you are planning for treatment in Turkey
you can talk to us here.