Aneurysm coiling, also known as endovascular coiling, is a less invasive procedure for treating aneurysms in the brain. Aneurysm coiling offers a shorter recovery time and fewer complications than surgical treatment of ruptured and unruptured brain aneurysms. If your doctors have determined that aneurysm coiling is right for you, the following topics will help clarify your treatment expectations: preparing for surgery, the day of surgery, during the procedure and post-op recovery.
Aneurysms and Treatment Options
An aneurysm is a weakened area in the wall of an artery that supplies blood to the brain or other areas of the body. This weak spot balloons outward and fills with blood. Aneurysms can enlarge and put pressure on the brain, or they can rupture, causing a stroke. Aneurysms can arise from unknown causes, or they can be linked to genetic diseases, such as polycystic kidney disease.
Aneurysm Treatments
Treating an aneurysm depends on a variety of factors, including the size and location of the aneurysm and the age and health of the individual who has it.
In some cases, unruptured aneurysms can be treated with medication and lifestyle changes. In others, a traditional brain surgery with a clip may be recommended. Thanks to growing technological capabilities, more and more people can be treated with coiling procedures.
In an endovascular aneurysm coiling procedure, flexible platinum coils are placed into an aneurysm through a catheter inserted in the groin. The coils fill the aneurysm and encourage clotting to seal off the bulge from the main artery. In some situations, a stent might be placed into the artery wall as a “scaffold” to keep the coils in place. Aneurysm coiling is performed by specially trained neurosurgeons under general anesthesia in a hospital setting.
Preparing for Your Aneurysm Coiling Procedure
In the days just before your aneurysm coiling procedure, you can expect to have a series of tests, including general blood tests and a CT or MRI scan. If you regularly take medications, you may be asked to discontinue them or change your dosage.
Because this procedure requires general anesthesia, no eating or drinking is allowed for eight hours before surgery. If you must take medications during that time, discuss your situation with your doctor.
Click here for our full guide to preparing for your aneurysm coiling procedure.
The Day of Surgery
The day of your procedure begins with checking in at the hospital, followed by preparation for surgery. Since aneurysm coiling is performed through an incision into the large artery in the groin, that area will be shaved. After that, you will be given anesthesia to sleep through the procedure, which typically lasts about 2 to 4 hours.
During the Procedure
An aneurysm coiling procedure is performed by neurosurgeons with the support of a team of nurses and imaging specialists. They are responsible for real-time monitoring of the location and placement of the catheters, stents and coils. The procedure begins with a small incision in the groin for access to the large artery, known as the femoral artery, leading to the brain. A catheter is threaded into the artery and directed through it to the location of the aneurysm.
Once the catheter reaches the aneurysm, a stent may be placed in the artery at the site. Then, a coil of platinum wire about the thickness of a human hair is inserted into the aneurysm itself. To fill the space, multiple coils may be used. The coil is released with an electric charge that also helps to promote clotting. Once the coiling is completed, the catheters are withdrawn and the incision in the groin is either sealed or stitched closed.
Recovering in the Hospital
Patients who undergo the procedure after an aneurysm has ruptured can expect to stay in the hospital for a week or more.
After the coiling procedure is completed, expect to recover in the hospital’s intensive care unit while you wake up from anesthesia. During this time, you will be monitored for signs of complications, which can include transient problems with speech, movement or vision. You may be advised to lie flat to avoid causing bleeding at the incision site or a rise in blood pressure.
Without complications, most people are able to return home within a day or so of the procedure, and can continue their recovery at home.
Recovering at Home
Because aneurysm coiling is less invasive than a traditional, open surgery, recovery time is typically shorter, and many people return to most daily activities within a few days. During this time, you may be prescribed medications for pain and discomfort and given instructions for caring for the incision site. Full recovery will depend on the circumstances of the patient before the procedure, but most patients who undergo a coiling procedure for an unruptured aneurysm can expect to fully recover within 2 weeks.
Follow-up visits in the weeks after the procedure are scheduled to monitor your recovery, and check the healing of the incision site. Your doctor may also order periodic CT or MRI scans to check the status of the aneurysm and the placement of the coils.
In most situations, aneurysm coiling resolves an aneurysm and prevents a rupture. In some cases, coils can settle, so that another procedure is needed to insert more coils to completely fill the aneurysm.
Options for treating an aneurysm depend on each individual’s unique circumstances and an aneurysm coiling procedure may not be appropriate for everyone. If aneurysm coiling is right for you, this minimally invasive procedure offers fewer risks than clipping surgery and a faster return to normal life.
