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Spring 2006

Less Invasive Procedure Stops Brain Aneurysm Bleeding

Study shows endovascular coil is an effective treatment following the rupture of an aneurysm

A less invasive procedure that has proven beneficial to prevent bleeding into the brain from a cerebral aneurysm has proven superior in appropriate patients whose aneurysm has ruptured.
Traditionally, patients with a ruptured brain aneurysm undergo an extensive emergency surgery to open up the brain and clip the aneurysm to prevent bleeding, notes Gary Duckwiler, M.D., UCLA interventional neuroradiologist.
A recent clinical study found that while the majority of patients still should be treated by the proven microneurosurgical clipping techniques, a certain number of patients with ideally configured aneurysms may be better treated by the less invasive endovascular coiling procedure. An aneurysm is a balloon-like structure attached to an artery whose rupture -known as a subarachnoid hemorrhage -results in bleeding into the space around the brain. "The consequences of subarachnoid hemorrhage are devastating, with approximately 70 percent of people either dying or suffering a severe stroke, " Dr. Duckwiler explains.
In the minimally invasive procedure, the endovascular coil is introduced into the brain through a catheter threaded from a blood vessel in the patient's groin. When the catheter is in position at the opening to the aneurysm, the coil is advanced and assumes the shape of the aneurysm. Successively smaller coils are added until the aneurysm is filled with coils to seal off the aneurysm and stop further blood from entering.
While the recent international study focused only on those patients who were good candidates for either procedure, both approaches are offered at UCLA, depending upon which is best for the patient, Dr. Duckwiler says.
With modern neuroimaging techniques, aneurysms are sometimes discovered before they rupture, and can be treated with an endovascular coil to seal them off from the blood supply and prevent a rupture. The first endovascular coil was developed at UCLA in the late 1980s.

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