Aneurysm
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.
|
