In this blog, we are throwing some lights on “Neuro Endovascular coiling”. You will get to know all those important details of Neuro Endovascular coiling that will help you take better decisions about discussing the risks and benefits of aneurysm coiling procedures with a doctor.
What is Aneurysm?
An aneurysm in the brain is a weak area in an artery in the brain that bulges out and fills with blood. In some of the cases, it balloons out of the thinned vessel wall can lead to dangerous complications if ruptures.
Once brain aneurysm is diagnosed by neuroimaging DSA or CT angiogram, after discussing benefits and risks of coiling of aneurysm coiling procedures undertaken. One should discuss the risks and benefits with a doctor.
Usually coiling procedure is suitable for aneurysms in posterior circulation that is vessels supplying the brain stem and cerebellum, narrow neck of aneurysm. You should always discuss with neurosurgeons about the coiling and other approaches, benefits and risks.
Endovascular coiling is usually carried out under general anaesthesia in a cath lab.
It is usually done from an artery in the groin called the femoral artery. Other arteries can be radial or brachial arteries in hand. Here catheters and micro guide wires are used to reach the area of the aneurysm.
Platinum coils are used to fill the aneurysm and seal that prevent the rupture. Sometimes additionally balloons or stents are used to facilitate the filling of platinum coils.
How you should be prepared for an endovascular coiling?
- In order to do the procedure, you will be asked to read the consent form carefully and sign it as well
- Share all your information regarding your reactions or allergies to alternative dyes or iodine
- Do follow the advisories given by the doctor before surgery
- The news regarding pregnancy shall be shared
- Blood tests are necessary so as to see how much time does it take to clotting of blood
- Tell the doctor about the medicines and supplementary you have been taking
Endovascular Coiling Procedure:
A coiling procedure will require you to stay in the hospital. Procedures may differ depending on your situation and the procedures of your surgeon or practitioner.
- Any clothing, jewellery, hairpins, dentures or anything that could interfere with the treatment will be asked to remove but generally, a hospital gown will be provided to you
- Before the treatment begins, you will be given time to empty your bladder
- On the X-ray table, you will be positioned on your back
- In your hand or arm, an IV (intravenous) line will be started
- An electrocardiogram (ECG) monitor will be attached to you, which will record your heart’s electrical activity
- During the process, you will have your heart rate, blood pressure, breathing rate and nervous system indication checked
- To drain your bladder, a catheter may be inserted
- Your pulses may be checked below the groyne area where the catheter will be put by the radiologist or neurosurgeon
- A guide will be used to insert a catheter into the artery in your groyne
- Fluoroscopy will be used to guide the catheter through the blood artery into the brain
- This is a sort of X-ray that resembles an X-ray movie
- Contrast dye will be given after the catheter reaches the afflicted artery in the brain, allowing the aneurysm and surrounding blood vessels to be seen on X-ray
- The aneurysm will be measured and its shape and other characteristics will be recorded by the provider
- The initial catheter will be replaced with a smaller catheter by the physician
- The provider will insert the coil into the aneurysm once the catheter has reached it
- The coil is removed from the catheter once it has been entirely inserted into the aneurysm
- The doctor will insert as many coils as necessary to seal the aneurysm
- Inside the aneurysm, the coils will form a mesh-like structure
- The catheter will be removed once the aneurysm has sealed. In the end, the dressing will be done
There are certain risks present in this neurosurgical procedure so always consult the Best Neurosurgeon in Bangalore. There have been cases of bleeding in an aneurysm and recanalization. Endovascular coiling may not be a complete success in all the patients.
When the procedure is going on, complications such as aneurysm rupture or stroke may arise. Aneurysms can be prevented from rupturing by preventing blood flow into them.
Other risks involved are:
- Blood clot
- Rupture of aneurysm
- Loss of consciousness
- Paralysis on half of the body
- Transient ischemic attack
Endovascular coiling is a minimally invasive surgery, there no craniotomy or cutting of bone, no opening of the brain, no retraction of brain or handling of blood vessels, get discharged faster and going back to normal life is fast.