Interventional Neuroradiology
Aneurysm Coiling
Brain aneurysms occur when a bulge develops in a weakened area of an
artery wall. Sometimes this can cause headache or other symptoms.
Unfortunately, most patients do not realize that they have an aneurysm
until it ruptures, which can cause severe neurologic injury or even death.
Many patients, however, can make a good recovery with intensive
neurosurgical care.
Traditionally treatment involves a major brain operation that closes the
aneurysm using a surgical clip. Some patients are not good candidates
for surgery because of their condition or other factors or because their
aneurysm involves a high element of risk due to its location.
Closure of such aneurysms (ruptured and unruptured) can often be done
now through embolization (blockage), using platinum coils. While the patient
is under general anesthetic, a catheter is moved from the groin to the neck
within the carotid or vertebral artery. A microcatheter is advanced within the
main catheter until the tip lies within the aneurysm. Platinum coils - finer than
a human hair - can then be moved into the aneurysm until the aneurysm is
completely filled. This technology is now in worldwide use and demonstrates
very satisfactory results. Patients awaken from anesthesia with only a bandage.
CT shows a large frontal parenchymal hemorrhage.
MR shows the aneurysm in the midst of large hemorrhage and edema.
AP and lateral angiograms show an aneurysm in the ophthalmic segment
of the internal carotid artery adjacent to the anterior clinoid process. 
Intraprocedural roadmap angiogram shows a coil being placed into the
aneurysm through a microcatheter.
Final skull x-ray shows the coil pack configuration.
Final angiograms show the aneurysm completely occluded by platinum coils.
