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 weak-walled outpouchings can bleed or burst, causing stroke, neurological damage or even death.
Flow diversion is a modern treatment that uses a stent — or braided metal tube — that is placed inside the vessel across the weak-walled aneurysm to enable it to heal. The technique is performed through catheters (long skinny plastic tubes) and requires only a small opening of the groin or wrist area, which is why it’s called “minimally invasive.” Once an aneurysm is cured with a flow diversion stent, worldwide there has never been a recurrence (an aneurysm that comes back after treatment). This is the only form of aneurysm treatment that has never had a recurrence.
How is flow diversion done?
Endovascular flow diversion 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. The tiny catheter is navigated past the aneurysm without having to enter the aneurysm. Then, the flow-diverting device (also known as a flow diverting stent) is deployed across the neck of the aneurysm in the parent blood vessel where the aneurysm is present.
Almost immediately the blood flow to the aneurysm is reduced. The complete closure of the aneurysm typically occurs at around six months after the procedure.
What are my risks? What are common complications?
All medical procedures have risks. The risks of flow diversion can include bleeding at the site where the artery is entered, injury to the blood vessels surrounding the aneurysm, formation of blood clots on the stent or one of our catheters or guide wires, 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 (non-surgical) procedure is performed in the hospital in the neurointerventional radiology area and typically takes 1½ – 3 hours. Preparation generally begins a few days prior to the procedure date. Patients will be prescribed antiplatelet medications to start beforehand, which will continue for some time (typically at least six months) afterwards. You will have an overnight stay in the intensive care unit following your procedure.
Patients should not eat or drink anything after midnight on the night before treatment. On the morning of the procedure, patients should take all 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 inserted 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).
- 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 may 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 towards normal.