Non-Surgical Brain Aneurysm Treatment

An aneurysm is an abnormal bulge in the wall of an artery due to weakness or injury to one or more of the three layers of tissue.  Most are likely the result of a genetic alteration, although infection, trauma, or atherosclerosis can cause aneurysms.  Many patients are asymptomatic or present with mild headaches.  40% of patients may have warning signs such as localized headache, cranial nerve paralysis, nausea or vomiting. 

Rupture of an aneurysm is a life threatening event; almost one third of patients who suffer an aneurysmal rupture will die despite the best medical therapy.  Typically, patients who have a ruptured aneurysm will have "the worst headache of their life”.  If this happens, you should all 911 immediately.  Patients with unruptured aneurysms are referred to the Neurosurgery/Neuro Interventional Radiology Offices.

Options for treatment of an aneurysm include coil embolization, which is done through a catheter inside the artery.

How do I prepare for the procedure?
You will be scheduled for a consultation with the Neurointerventional Radiology Team. Bring a list of questions to ask your doctor. It is important that you understand exactly what procedure is planned, the risks, benefits and other options before your procedure. Occasionally, patients are given a prescription for Plavix and full strength Aspirin.  It is CRITICAL that you take this medication as directed.  You will undergo General Anesthesia for this procedure and we will request that a pre-operative evaluation is done by your Primary Care provider, clearing you for the procedure.

What happens during the procedure?
Your vital signs will be monitored by an Anesthesiologist.   You will have an IV in place and a Foley catheter to empty your bladder.  You will also be receiving medication to help you relax.  You will lie on your back during the procedure. The technologist will prepare the skin over the groin by cleaning it with an antiseptic solution and place sterile drapes and towels over you to create a sterile work space. Lidocaine local anesthesia is injected into the skin overlying the common femoral artery in the groin. The Neurointerventional Radiologist will then pass a small catheter (a tiny tube) through an artery in your groin region to the blood vessels in your neck and then take pictures of the affected blood vessel.    The Neurointerventional Radiologist then uses an even smaller catheter to navigate into the aneurysm.  Small platinum coils are then passed through this tiny catheter to fill the aneurysm and prevent bleeding.  In complicated aneurysms a temporary balloon or a stent may be placed to hold the coils in place. At the end of the procedure, the catheters are removed, and the access site in the femoral artery is sealed using a closure device or manual compression.

What happens after the procedure?
You will be brought to the Intensive Care unit and watched closely by the health care team.  In the first 6 hours of recovery, patients are monitored closely for signs of bleeding from the artery in the groin.

Going Home:
Since the arterial blood flow is a high pressure system, patients should refrain from lifting more than 10 lbs, refrain from strenuous activity or anything which causes abdominal distension for the following 48-72 hours. Any straining such as vomiting, coughing, forced bowel movements could dislodge the clot that forms to seal the artery and cause bleeding.

Do not take a tub bath, go in a hot tub or submerge in water for 5 days. Leave the sterile dressing on for 24 hours, then shower and clean the area daily.  Place a clean Band-Aid over the site each day for 5 days. Report any signs of infection (redness, swelling, discharge and fever) to your doctor. At home, you can eat normally, but you should continue drinking extra fluids for 1 to 2 days after your procedure. What kind of follow up is needed?

Approximately one week after procedure you will schedule an office visit with the Neurointerventional Radiology Team. Surveillance imaging (MRI or CT scans) and office visits will be required at regular intervals.
If you have any questions please feel free to contact the Interventional Radiology Office at 802- 847-8359 Monday – Friday 8 a.m. to 5 p.m.

This information is provided by the Fletcher Allen , Department of Radiology, Division of Interventional Radiology and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact your health care provider.