An aneurysm is a small balloon that forms on a weakening wall of a blood vessel. It is estimated that about 2 to 4% of the world’s population have cerebral aneurysms. Cerebral aneurysm diagnoses are becoming more common as they are found when the patient is imaged for other reasons such as car accident or headaches. Aneurysms are a cause for concern because they can rupture and when they do, have potentially life threatening consequences. One-third of patients die when an aneurysm ruptures. Other complications of a rupture include permanent disability and long recovery back to baseline.
Aneurysm: Surgical Clipping and Endovascular Treatment
In order to treat an aneurysm, the blood flow to that aneurysm must be blocked. Creating this block prevents the aneurysm from rupturing.
There are 2 approaches to treat cerebral aneurysms. These are clipping and coiling.
Clipping:
During surgery, a small hole is made in the bone. Once the aneurysm is located, a clip is placed to close it off. Clipping was the original way to take care of aneurysms and it has been around for decades.
Coiling:
An endovascular technique was developed in the mid-90’s which is called coling. Coiling is done by accessing an artery either in the wrist or in the groin and snaking up into the aneurysm. The aneurysm is then treated with a variety of different tools. Coils were originally used. Stents and flow diverters are now used to block the aneurysm internally.
Patients tend to prefer endovascular treatment because it is less invasive with a shorter hospital stay. Ultimately, the surgeon will decide the best treatment for the aneurysm. Factors including aneurysm location and relationship to other blood vessels can be deciding factors on open versus endovascular surgery.
