Endovascular aneurysm treatment

Various treatment options

The Department of Neuroradiology offers several treatment options:

Coil embolization

Coil embolization involves inserting a fine microcatheter through the blood vessels into the aneurysm. The aneurysm is then filled with platinum coils, resulting in rapid blood clotting which eliminates it. Coil embolization with platinum coils as used today was first performed in 1990. Over the years it has proved to have low complication rates and to be highly effective. It is now the most commonly used treatment for intracranial aneurysms.

Flow-Diverter Stent

In this method, a flexible, very fine metal mesh is placed over the aneurysm which diverts the blood flow away from it. The advantage of the stent method is that larger diseased vessel segments with multiple aneurysms can be treated in one step. After insertion of a flow-diverter stent, blood-thinning medication must be taken for one year.

Advantages and disadvantages

Advantages

• Endovascular aneurysms are treated with minimally invasive methods and therefore require only a short hospital stay, and have low complication rates. The alternative is classical neurosurgery which is a longer procedure and is much more invasive.
• Endovascular treatment is suitable for any type of aneurysm.

Disadvantages

• A small proportion of those treated may experience recurring aneurysms (= reperfusion of parts of the aneurysm) after coiling.
• Very small aneurysms are usually not treated unless the patient has risk factors for hemorrhage.

Course of treatment

Treatment starts with the diagnosis and the decision to use minimally invasive methods. After discussing this with you during a consultation, we will schedule a timely appointment, which is in keeping with the urgency of your case and your special wishes.

The treatment requires a hospital stay of three to four days. You will arrive the morning before the procedure and we will assess your status and make the final preparations. We will use this opportunity to answer any questions you might have. On the day of the procedure, you will be taken from the ward to one of our two operating rooms, where the surgical team will meet you and perform the procedure.

Aftercare

Immediately after the procedure, you will be examined to make sure everything went well. We will then transfer you to a specialized monitoring ward where you will be cared for until the next day. On the following day, you will undergo a magnetic resonance examination to assess the surgical outcome and rule out any complications. Normally, you will then return to the standard ward and after another one or two days you will consult with a specialist and can then go home. During this last consultation, we will schedule appointments for further check ups.