Aneurysm coiling is a less invasive procedure for treating cerebral aneurysms, including those that have ruptured, causing bleeding in the brain. The coiling procedure has relatively fewer risks and a shorter recovery time than open surgery. Recovery time for ruptured aneurysms will vary depending on how severe the rupture is and how serious neurological defects are, because of these factors full recovery can range from a month to potentially years.
What Is an Aneurysm Coiling Procedure?
An aneurysm develops when an artery in the brain develops a weak spot that balloons outward, filling with blood. In some situations, the aneurysm can swell and burst, so that blood leaks into the brain, which can cause a stroke. A ruptured aneurysm is a medical emergency that requires fast treatment to prevent serious neurological symptoms or even death. For many people, the right treatment is a coiling procedure.
Ruptured aneurysms can also be treated in an open surgical procedure called clipping, in which a clip is inserted into the artery at the aneurysm’s neck to close off its supply of blood from the parent artery. Since coiling is an endovascular procedure that treats the aneurysm through catheters inserted into the large femoral artery in the leg, it is less invasive, faster and generally equally as safe for those who cannot undergo traditional surgery, such as a clipping procedure.
Coiling is not right for everyone who experiences a ruptured aneurysm. Neurosurgeons can determine whether to treat the aneurysm with clipping surgery or with coiling, depending on the patient’s age, general health, the location and size of the aneurysm.
Aneurysm coiling takes around one and a half to three hours and is typically done under general anesthesia. A small incision is made in the femoral artery and with the help of contrast dyes and imaging technology, a catheter is guided through the artery, past the heart and into the brain. At the aneurysm site, flexible platinum coils are introduced into the aneurysm.
When completely packed into the aneurysm, the coils block the flow of blood from the artery to the aneurysm and encourage clotting, so that the aneurysm is sealed. After the catheters are withdrawn, the groin incision is closed and your recovery begins.
Recovery in the Hospital
Right after surgery, you will be taken to the hospital’s intensive care unit for monitoring while the anesthesia wears off. For at least six hours after the procedure, you will need to lie flat with your bandaged leg outstretched. During this time, staff will continue monitoring your vital signs and responses to check for complications from the ruptured aneurysm or from the procedure itself.
After a ruptured aneurysm, recovery from a coiling procedure typically involves a hospital stay of 14 to 21 days or longer, depending on issues caused by the rupture and any other factors that might affect your recovery, such as other health conditions.
During this time, staff will continue to monitor your recovery and watch for complications that can occur in the days and weeks after an aneurysm rupture and from the coiling procedure itself. These kinds of situations can include re-bleeding of the aneurysm, swelling of the brain, or vasospasm – a sudden narrowing of the artery that can occur five to 10 days after an aneurysm rupture. If the rupture caused neurological problems such as speech, coordination or vision difficulties, you may also receive therapy and other support for managing these symptoms after you go home.
Recovery at Home
In the coiling procedure, you can gradually return to normal activities as tolerated, as it is likely that you will be fatigued and tired. Everyone will recover at their own pace and it is important to remain patient and follow the instructions of your surgeon. Many people will need rehabilitation services following an aneurysm rupture, and you will be evaluate for those before being sent home from the hospital.
The First Week
For the first week after you return home, you can expect some restrictions on activities, especially lifting. Without any complications from the procedure or restrictions related to the aneurysm rupture itself, you may be able to resume driving and return to work or school within one or two weeks, assuming that your neurosurgeon and neurologist have provided clearance to do such.
The Second Week
During the next few weeks, you will need to follow your doctor’s discharge instructions regarding care of the incision and other guidelines for your recovery.
You can expect to experience headaches, fatigue and nausea during your recovery. You might also have transitory problems with short-term memory and concentration. Your doctors may prescribe medications to help with symptoms such as headaches and nausea.
The First Month and Beyond
In the first month of your recovery from a coiling procedure, you can expect to see your doctors for a follow-up to check your healing and progress. If needed, you may also be referred to physical therapy to manage any long-term problems caused by the ruptured aneurysm.
As your recovery progresses, you can expect to see your doctors for follow-ups at intervals of about three months, six months, one year and two years post-surgery if no problems with your coiling procedure present themselves. These follow-ups typically include imaging tests such as angiography and CT scanning to check the placement of the coils and determine whether they have become compacted, or settled into the aneurysm so that the blood flow is no longer completely blocked.
The aneurysm coiling procedure can resolve an aneurysm with no need for further treatment, and for many people who have experienced a ruptured aneurysm, it offers a less invasive alternative than clipping surgery. Your doctors can work with you to create the right ruptured aneurysm recovery plan for your unique circumstances so you can return to daily life as quickly as possible.
