HWN Suggests

Intracranial aneurysms: Review of current science and management

Aneurysm clipping, which was first reported by Walter Dandy in 1938, remains a reliable and efficient way of treating cerebral aneurysms. Endovascular coiling was first reported in 1990 and 1991. The first self-expandable neuro-specific intracranial stents became available in the early 2000s, followed by several others later on. Flow diverter therapy first appeared around the mid-2000s for investigational use, and has become widely popular after the initial safety and feasibility trials were completed. Since then, upgraded versions of previously available coils, stents, balloons, flow diverters, as well as many other new adjunctive intra- and extraluminal devices, have been developed for the…

read full article

Articles of Interest

Aneurysm Surgery – What Is Involved

The operation has as its aim the “clipping” of the aneurysm at the base of its neck (just like tying off a balloon) so that it is eliminated from the blood circulation of the brain. Aneurysms can also be cured by other techniques in selected cases. A revolution (some call it a rapidly expanding evolution) is occurring in the technology of “interventional radiology,” allowing doctors to fill aneurysms with metal coils, glue, balloons, and even “stents.”

Brain Aneurysm Coiling

UW Medicine neurosurgeon Raj Ghodke treats a patient's brain aneurysm with a procedure called endovascular coiling to halt the risk of bleeding.

Brain Aneurysms Need Watching, not Worrying

Once an aneurysm is found, it requires a careful evaluation by a specialist who understands the risk an aneurysm could pose to the patient. Medical studies show the risk of a brain aneurysm rupturing is quite low. In some cases, this risk can be less than half a percent per year and most brain aneurysms fall into this low-risk category. In these cases, neurosurgeons do not recommend treatment given the low risk to the patient. However, all aneurysms are followed with brain imaging studies over several years to ensure they are not growing.

Current Treatment Strategies for Intracranial Aneurysms: An Overview

Conventional treatment options for IAs are either surgical or endovascular. However, conventional treatments are insufficient when dealing with special IAs or in complex cases. Innovations in both surgical and transluminal techniques have been developed over the past years.

Endovascular Coiling for Brain Aneurysms

A microcatheter is inserted through the initial catheter. The coil is attached to the microcatheter. When the microcatheter has reached the aneurysm and has been inserted into the aneurysm, an electrical current is used to separate the coil from the catheter. The coil seals off the opening of the aneurysm. The coil is left in place permanently in the aneurysm. Depending on the size of the aneurysm, more than one coil may be needed to completely seal off the aneurysm.

Techniques for Cerebral Aneurysm Treatment

Current research aims to expand the tools available for endovascular treatment of this challenging disease.

The evolution of intracranial aneurysm treatment techniques and future directions

Treatment techniques and management guidelines for intracranial aneurysms (IAs) have been continually developing and this rapid development has altered treatment decision-making for clinicians. IAs are treated in one of two ways: surgical treatments such as microsurgical clipping with or without bypass techniques, and endovascular methods such as coiling, balloon- or stent-assisted coiling, or intravascular flow diversion and intrasaccular flow disruption.