Minimally invasive treatments for brain aneurysms
Dr. Peter Sunenshine is a neurointerventional radiologist on staff at Banner – University Medical Center Phoenix. His office can be reached at (602) 839-5097.
Question: With minimally invasive procedures now being used to treat a variety of conditions, can you discuss what types of minimally invasive treatments are available for brain aneurysms?
Answer: Aneurysms, whether in the brain or any other part of the body, are balloon-like protrusions from the weakened wall of a blood vessel, often an artery. Presumably, the bigger an aneurysm gets, the thinner the vessel wall becomes and the greater the risk of rupture.
We have two primary concerns when it comes to brain aneurysms. The first is a rupture, which can be devastating. Roughly 50 percent of people who suffer a rupture will not make it to the hospital. Of those who do survive, more than half will have cognitive and/or physical disabilities, according to the Brain Aneurysm Foundation. The other concern is what we call the mass effect. This occurs when the aneurysm grows large and presses against nerves and structures of the brain. This can lead to a variety of neurological symptoms, such as blurring or loss of vision, dizziness, headaches, stroke-like symptoms, and more.
Fortunately, we have interventional, or minimally invasive, treatment techniques that are effective in treating ruptured and unruptured aneurysms. The most common interventional technique we use is called coiling. With coiling, a small catheter is inserted into the femoral artery in the leg and precisely guided through the vessels until it reaches the location of the aneurysm. Then, very fine platinum coils are released into and fill the aneurysm, in effect sealing it off from the vessel without interrupting blood flow.
A second, and newer, technique that we use with complex aneurysms (when coiling isn’t appropriate or possible) is the use of flow diverter stents. As with coiling, a catheter is used to deliver the flow diverter stent to the location of the aneurysm. The stent is then placed across the neck of the aneurysm, essentially blocking off the aneurysm and diverting the flow of blood away from it. Over about six months, the aneurysm shrinks.
Both procedures are effective in preventing future ruptures and in alleviating the mass effect by reducing the size of the aneurysm. After either procedure, the progress of patients is monitored to make sure the aneurysm remains well treated.
If you have any additional questions about interventional treatments for brain aneurysms, talk with your healthcare provider.