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Endovascular Coiling

In the past, standard care for an intracranial aneurysm was to place a clip similar to a bobby pin on the neck of the aneurysm to stem the bleeding. This operation involves a craniotomy, the cutting of a hole in the skull.

Endovascular coiling, a new form of therapy offered at St. Joseph's Hospital's Neuroscience Institute, results in better outcomes with decreased danger the patient. With endovascular coiling, platinum micro coils, similar to very tiny springs, are placed in the aneurysm via a tiny tube. These coils fills the aneurysm, causing it to clot. The chance of re-bleeding is decreased to nearly zero.

Can I consider myself cured after undergoing a coiling procedure?
Unfortunately, not necessarily. Even after successful treatment of a subarachnoid bleed, numerous postoperative problems may arise. For this reason, it is important for you to spend up to 2 weeks in a neurosurgical intensive care unit. There, medical professionals will monitor pressure and blood flow within the skull; blood circulation and cardiac function; pulmonary status; and neurological condition. The aim of patient management in the intensive care unit is to prevent or reduce all complications.

What conditions may arise following the rupture of an intracranial aneurysm?
Epileptic seizures occur in 20 percent of all patients. These generally result from the intracranial hypertension (high blood pressure) that appears in virtually all patients after rupture.

Obstructive Hydrocephalus – or a buildup of cerebrospinal fluid in the skull – affects 20 to 25 percent of patients suffering from the rupture of an intracranial aneurysm, most commonly after severe hemorrhage. To treat this condition, physicians insert a shunt in the skull. The shunt drains off the excess fluid, relieving the pressure on the brain.

Vasospasm, or contraction and spasm of the blood vessels, occurs in nearly 33 percent of patients. The results of this condition range from severe headaches and fever to dementia or coma. Your physicians will use a Transcranial Doppler scan to see if you may be suffering from vasospasm. This noninvasive examination is extremely good at detecting the condition, and in helping your doctor determine the best treatment available for you.



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