Endovascular coiling - treatment of brain aneurysms

Endovascular coiling - treatment of brain aneurysms

Endovascular coiling for the treatment of cerebral aneurysms, what is this procedure, suitable patients for it, the cost of the procedure in Turkey.

Endovascular coiling is a new technique that treats aneurysms prophylactically for non-bleeding aneurysms or curatively after bleeding without opening the skull with X-ray guidance, reducing its complications compared to other procedures. Therefore, your doctor may advise you to treat cerebral aneurysms that are prone to bleeding by the endovascular coiling method. Endovascular coiling remains a procedure that is not suitable for all patients.

What is a brain aneurysm?

An aneurysm (known as a cerebral aneurysm) is a weakened area in the wall of an 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 it exceeds a certain size, cerebral hemorrhage is an emergency situation that may be fatal.
This type of aneurysm is known as a thymus aneurysm, or cystic aneurysm, based on the way it appears. If the cerebral aneurysm ruptures, it causes 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 artery walls, or spindle aneurysm; When an entire artery swells.

The exact cause of aneurysms is unknown. The causes can be hereditary (inherited in families) or occur to the pregnant woman due to a defect during pregnancy.

Some diseases can lead to weakness in the walls of the arteries and the formation of aneurysms.

These include polycystic kidney disease, some connective tissue disorders, or abnormalities of the blood vessels.

Injury, high blood pressure, or drug use may also increase the risk of developing aneurysms.

In rare cases, infection within the artery wall can cause aneurysms to form.

What is endovascular coiling?

Alf angioplasty is a method of treating aneurysms without opening the skull or performing brain surgery.

A coil (or coil) is a fine, thin wire that is collected inside the aneurysm. The IUD blocks blood flow into the aneurysm by forming a blood clot that helps block it, while the rest of the artery remains open to carry 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 aneurysmectomy (surgically separating an aneurysm by placing a clip at its base to prevent blood from entering), which requires brain surgery and opening the skull to isolate the aneurysm.

Who needs endovascular coiling?

Many patients can undergo endovascular coiling. This procedure can be done whether the aneurysm is healthy or torn.

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

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; Some sedation 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 precisely locate the aneurysm by x-raying the capillaries and surrounding blood vessels. 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 admitted to the hospital for several days or weeks.

There are usually some restrictions on activity for several days after the endovascular coiling procedure, including no driving or work and some weightlifting 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 now make very small incisions to access the aneurysm, which reduces disability and length of recovery for 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.

If an aneurysm has ruptured, recovery may take weeks to months. Depending on which area of the brain the aneurysm is in, permanent brain damage may occur.

What are the potential risks and complications of intravascular bypass?

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

There are some potential risks associated with wrapping the blood vessels. These can include injury or damage to the artery or aneurysm that is being treated; In rare cases, an aneurysm can rupture.

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 coils as they are 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.

Coils may not stay in place or may not block the aneurysm completely; If this happens, the aneurysm may increase in size and enlarge. Patients may have an allergic reaction to the dye used during the procedure. With any procedure, there is a risk of infection.

What is the cost of endovascular coiling?

Specific costs for vascular coils are not available. Many factors play a role in determining the cost of the procedure, including whether the aneurysm has actually ruptured, the patient's age, the presence of associated diseases, whether hospitalization is needed after the procedure, and the number of aneurysms for which treatment is directed.

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Common Questions

A non-ruptured aneurysm is often asymptomatic, but because the skull is a closed box that does not expand, aneurysms may cause a rise in intracranial pressure, causing vision problems, sometimes movement disorders, 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 Study Patients were followed for a long time. 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%

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