How are aneurysms treated?
The main goals of treatment once an aneurysm has ruptured are to stop the bleeding and potential permanent damage to the brain and to reduce the risk of recurrence. Unruptured brain aneurysms are also frequently treated to prevent rupture. Patients with unruptured brain aneurysms have significantly better outcome following treatment than patients presenting with a ruptured aneurysm.

Surgery or minimally-invasive endovascular coiling techniques can be used in the treatment of brain aneurysms. It is important to note, however, that not all aneurysms are treated at the time of diagnosis or are amenable to both forms of treatment. Patients need to consult a neurovascular specialist to determine if they are candidates for either treatment.

Surgical Treatment
To get to the aneurysm, surgeons must first remove a section of the skull, a procedure called a craniotomy. The surgeon then spreads the brain tissue apart and places a tiny metal clip across the neck to stop blood flow into the aneurysm. After clipping the aneurysm, the bone is secured in its original place, and the wound is closed.

Minimally-Invasive Treatment (Coil Embolization or Endovascular Coiling)
Endovascular therapy is a minimally invasive procedure that accesses the treatment area from within the blood vessel. In the case of aneurysms, this treatment is called coil embolization, or "coiling".  In contrast to surgery, endovascular coiling does not require open surgery. Instead, physicians use real-time X-ray technology, called fluoroscopic imaging, to visualize the patient's vascular system and treat the disease from inside the blood vessel.

Endovascular treatment of brain aneurysms involves insertion of a catheter into the femoral artery in the patient's groin and navigating it through the vascular system, into the head and into the aneurysm. Tiny platinum coils are threaded through the catheter and deployed into the aneurysm, blocking blood flow into the aneurysm and preventing rupture. The coils are made of platinum so that they can be visible via X-ray and be flexible enough to conform to the aneurysm shape. This endovascular coiling, or filling, of the aneurysm is called embolization and can be performed under general anesthesia or light sedation. More than 125,000 patients worldwide have been treated with detachable platinum coils.

What is a coil?
When coils were first introduced in the early 1980s, aneurysms tended to rupture when the coil was detached. In the 1987, an Italian neurosurgeon by the name of Guido Gugliemi developed a coil that detached from a wire electrolytically, that is, with an electrical charge. The wire was delivered to the aneurysm cavity through a small tube or catheter placed in the artery. As a result, the coil could be placed, and retracted if placement was not optimal, without risk to the patient. The coils themselves are made of soft, spring-like platinum. The softness of platinum allows the coil to assume the shape of often irregularly-shaped aneurysms while posing little threat of rupture. Today, more than 1,000 patients are treated with GDC coils annually in the United States.

Do I need to prepare for this procedure?
In general, if you are undergoing general anesthesia or intravenous (IV) sedation, you will need to wait a minimum of 8 hours between your last food and fluids and undergoing anesthesia. If you will be receiving a local anesthetic, there is no need to prepare for this procedure. Prior to the procedure, an intravenous line (IV) will be placed in your hand or arm to administer medications and fluids during the procedure. Also, a flexible catheter will be placed in an artery in your wrist to monitor your blood pressure (A-Line). An EKG machine monitors your heart rate and rhythm and oxygenation continuously.

What type of anesthesia is used for this procedure?
This procedure may be performed under general anesthesia or with a local anesthetic.

How long does the procedure take?
The length of surgery varies according to the complexity of the case, including the shape and the size of the aneurysm. In general, the procedure takes approximately two hours.

How long can I expect to stay in the hospital? How long is my recovery period?
While individual experience varies, length of stay at UAMS averages 2 days for unruptured aneurysms. Most individuals recover rapidly.

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