Why is this procedure done?
A brain aneurysm, also called a cerebral aneurysm, is a weak spot along a blood vessel in the brain that bulges outward. Treatment of an aneurysm depends on factors including the size, location and shape of your aneurysm, whether or not it has ruptured, and your age and general health. Although some aneurysms may go undetected throughout life, these blood-filled sacs can enlarge, bleed or burst, causing stroke, neurological damage or even death. Coiling (also called embolization) and stenting are among the ways to treat aneurysms.
How are aneurysm coiling and stenting done?
Endovascular embolization is a treatment in which a catheter is inserted into an artery in your groin or wrist and threaded through the body to the site of the brain aneurysm. Detachable metal coils are passed through the catheter and then released into the aneurysm. The coils fill the aneurysm, preventing blood from flowing through it and causing it to close off. This decreases the chances of rupture or other future complications. Aneurysm coil embolization can be performed in both ruptured and unruptured aneurysms.
Stents are small metal tubes that are used for certain kinds of aneurysms. Stents can be placed at the same time as coils in order to make sure the coils are positioned perfectly inside of the aneurysm. Stents are also placed through the same catheters used for coil embolization.
What are my risks? What are common complications?
All medical procedures have risks. The risks of embolization can include bleeding at the site where the artery is entered, injury to the blood vessels surrounding the aneurysm, formation of blood clots inside of the blood vessels and adverse reaction to anesthesia. As with any medical procedure, you should talk to your doctor about the risks versus the benefits of the procedure.
What do I need to know before the procedure?
This minimally invasive (nonsurgical) procedure is performed in the hospital in the interventional radiology area and can take 1½ – 3 hours. Preparation generally begins a few days prior to the procedure date. Patients may be prescribed antiplatelet medications to start prior to the procedure and continue for a short time (weeks to months) afterwards. You will have an overnight stay in the intensive care unit following your procedure.
You should not eat or drink anything after midnight on the night before your procedure. On the morning of your procedure, you should take all your morning medications with a small sip of water.
General discharge instructions
- Keep the site clean and dry.
- You may have soreness, a bruise or a knot near where the needle was inserted for a few days to a few weeks. This is normal.
- Check the spot where the needle was put in for redness, pain, swelling and a lot of bleeding or drainage. Call us if this happens.
- You may shower the next day but do not soak the puncture site for two weeks (no tub bathing, swimming or getting in the hot tub).
- You may return to work three days after the procedure.
- No exercising, lifting objects greater than 10 pounds or strenuous activity for the next five days.
- If you take Glucophage (metformin or metformin products), do not take it for two days after the angiogram. On the third day, start again as prescribed.
What should I expect while recovering?
Because this procedure is minimally invasive, recovery is typically quite rapid. Most patients will go home the morning after the procedure is performed. We ask that you take it easy for five days to allow the artery access site to heal. that means no lifting heavy weights or vigorous physical exercise during the first five days. After that, you can return to normal activity. Some patients report feeling more tired than usual during the recovery period while the artery is healing, which can last a few months. Energy levels will typically wax and wane during this time period but will overall trend back toward normal.