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Aneurysms
An abnormal balloon-like bulging of an artery’s wall. As the artery bulges, it is weakened and its chances of rupturing increase. Aneurysms can form in any part of the body, but only those affecting the arteries supplying the brain can cause a stroke. The condition is worsened by hypertension, aging and atherosclerosis. If an aneurysm ruptures, blood flows into the brain, or a protective membrane surrounding the brain called the subarachnoid space. Aneurysmal subarachnoid hemorrhage is a medical emergency.
Treatments
Aneurysm Clipping
A surgical procedure that requires creating an opening in the skull through which the surgeon’s instruments can enter. The surgeon can then place a clip across the neck of the aneurysm (figure at right), preventing arterial blood from entering it. If there is a clot in the aneurysm, the clip also prevents the clot from entering the artery and possibly causing a stroke.
Coiling
This procedure involves the use of a soft platinum micro-coil (fig 2) that is inserted in a micro catheter through the femoral artery and threaded through the arteries and cerebral vessels to reach the aneurysm. After being properly positioned, the coil is released into the aneurysm by a very low voltage current. Once detached and in place, the coil fills the aneurysm (fig 3), isolating it from the circulation and thereby reducing the pressure and the likelihood of a rupture and a hemorrhagic stroke.
Balloon assisted coiling
This procedure involves coiling as above in combination with a tiny balloon catheter to aid in holding the coil in place.
Combination stent and coiling
This procedure involves coiling as above in combination with a stent (a small flexible cylindrical mesh tube) (fig at right) that provides a scaffold for the coil mass. This technique is very important on the management of wide neck and fusiform aneurysms.