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Brain Aneurysm Embolisation

What is Brain Aneurysm Embolisation?

brainBrain aneurysm embolisation or ‘cerebral coiling’, is a minimally invasive treatment for aneurysms around the brain.

An aneurysm is a bulge or sac that develops in an artery because the wall of the artery is weak. A bulging aneurysm may compress surrounding nerves resulting in nerve paralysis, headache or visual disturbance. If an aneurysm in the brain ruptures, the resultant bleeding may cause severe stroke or death.

During brain aneurysm embolisation your doctor will use X-ray guidance to place a series of small, soft metal coils into the aneurysm. This will block the flow of blood and prevent rupture of the aneurysm.

What sort of Aneurysms can be treated with Coiling?

Coiling may be performed on both ruptured and un-ruptured aneurysms. Not all aneurysms are suitable for coiling. Depending on the size, shape and position of the aneurysm some aneurysms may be better suited to coiling or to conventonal neurosurgery.

What does the equipment look like?

In this procedure a catheter and detachable coils are used. A catheter is a long, thin plastic tube, about as thick as a piece of spaghetti. Coils are made of soft platinum and come in different diameters and lengths. They are usually several millimetres in diameter and 5 to 50 centimetres long. Coiling has been scientifically proven to be safe and effective.

Other equipment that may be used in this procedure includes an IV cannula for medication administration and equipment that monitors your heart beat and blood pressure.

How does the procedure work?

In this procedure a long, thin catheter is inserted through the skin into an artery, using image guidance (X-ray). It is manoeuvred through the body to the site of the aneurysm or fistula. One or more coils are then inserted through the catheter and placed at the site of the weakened vessel, where it is then anchored. Your body will react by forming blood clots around the coil(s), which will help block the flow of blood into the aneurysm and prevent the aneurysm from rupturing.

How is the procedure performed?

Prior to your procedure a CT or MRI scan may have been performed. You will be seen by an anaesthetist that will be administering your general aesthetic and an IV cannula will be placed in the vein in your arm so that medication can be given to you throughout the procedure.

Prior to you going into the theatre your groin will be clipped (usually the right side) and you will need to sign a consent form for the procedure.

You will be positioned on the procedural table and connected to monitors that record your heart rate, blood pressure and pulse during the procedure. Your Anaesthetist may also decide to place a small cannula in one of your arteries in your forearm to monitor your blood pressure. Your groin will be sterilized and you will be covered from chin to toes with a surgical drape. At this point you will be asleep (anesthetized). Your doctor will numb the surgical area will local anaesthetic and a very small nick is made in the skin. Using X-rays a catheter is inserted into the skin and moved to the site of the aneurysm. Once in position the coils are detached in the aneurysm or fistula.

At the end of the procedure the catheter will be removed and pressure will be applied to stop the bleeding. The opening in the groin is covered with a dressing. No stitches are required.

You will be woken up from your general anaesthetic and transported to the Intensive Care Unit (ICU). Please note that this procedure is generally done under a general aesthetic and you will be unconscious throughout the length of the procedure.

This procedure usually takes 2–3 hours but may take up to 6 hours.

What you may need to tell your doctor or nursing staff looking after you:

  • If you have had a previous reaction to contrast
  • If you have kidney disease
  • If you are pregnant
  • If you have blood clotting problems
  • If you are taking blood thinning medication (Warfarin, aspirin, anti-inflammatory)

This is a safe procedure but a major one. The brain is a delicate organ and is easily damaged.

Risks include:

  • Technical failure—the aneurysm may not be able to be coiled for technical and/or anatomical reasons
  • Bruising (to the groin area)—most people will develop some degree of bruising
  • Damage to the inside of arteries
  • Bleeding
  • Stroke
  • There is a slight risk of death from a major complication
  • Regrowth of the aneurysm.

What are the benefits?

  • Coiling is effective in preventing aneurysm rupture and can reduce any associated symptoms.
  • No surgical incision is needed—only a small nick in the skin that does not have to be stitched closed.
  • Brain aneurysm embolisation is a treatment for cerebral aneurysms that previously were considered inoperable.
  • This procedure is less invasive and requires significantly less recovery time than open surgery for aneurysm repair. An additional benefit includes minimal blood loss.

You will be required to sign a consent form to say that the procedure has been explained to you fully, including risks and benefits. If you need any clarification please ask your doctor for more information before you sign.

Mater Private CardioVascular Unit

Mater Private Hospital Brisbane
Level 6, 301 Vulture Street, South Brisbane,
Queensland 4101
Telephone: 07 3163 6700
Bookings: 07 3163 1146 or 07 3163 1147
Facsimilie: 07 3163 6720

www.mater.org.au

Mater acknowledges consumer consultation in the development of this patient information.
Last modified 12/11/2015.
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