Endovascular Coiling for Brain Aneurysms

Endovascular coiling is a minimally invasive technique that can be used to block blood flow to an aneurysm and reduce the risk of rupture and bleeding.

An aneurysm is a bulge or a weakened area in the wall of a blood vessel in the brain. If an aneurysm ruptures, it can cause life-threatening bleeding and brain damage. Endovascular coiling is a minimally invasive technique that can be used to isolate an aneurysm from normal blood circulation without narrowing the vessel or blocking any nearby arteries. By depriving an aneurysm of blood flow, coiling can reduce the risk of rupture.

Who Is a Candidate for Coiling?

Coiling may be a treatment option for a patient who is diagnosed with a:

• Ruptured aneurysm – If an aneurysms bursts, it will release blood into the space between the brain and the skull, creating a subarachnoid hemorrhage. Because the risk of repeat bleeding is relatively high within the first 14 days after an initial brain bleed, immediate treatment such as coiling is essential.
• Unruptured aneurysm – Because most intact aneurysms do not cause symptoms, they are usually detected in an imaging scan of the brain performed for an unrelated reason. Treatment such as coiling may be considered for an unruptured aneurysm depending on its size, location and other factors that can increase the risk of rupture.

What Does Coiling Involve?

When performing an endovascular coiling procedure, a surgeon accesses the aneurysm from within the bloodstream via the femoral artery in a thigh. After inserting a thin, flexible tube (catheter) into the femoral artery, the surgeon guides the catheter to one of the four arteries in the neck that lead to the brain. To precisely “steer” the catheter, the surgeon creates a “roadmap” of the arteries with angiography, which involves injecting a special dye that makes blood vessels highly visible on an external monitor.

Once the catheter is in place, the surgeon inserts a series of thin platinum wires that coil up when entering the aneurysm. The surgeon will insert as many coils as needed to completely seal off the aneurysm. Over time, a clot will form inside the aneurysm, significantly reducing the risk of rupture.

What Can You Expect After a Coiling Procedure?

Recovery following endovascular coiling can vary, with some patients returning to their normal activities within a month while recovery may take others three to six months.

Is Endovascular Coiling Effective?

While there are some risks associated with coiling, including damage to the artery and vasospasm (a sudden narrowing of the artery), coiling is an effective way to reduce the risk of an aneurysm rupturing.

Tampa General Hospital is a state-licensed comprehensive stroke center with one of the largest neuroscience intensive care units in the nation. Our team of stroke specialists is available 24 hours a day, every day of the year, to perform prompt diagnoses, specialized treatments such as coiling and comprehensive rehabilitation services for our stroke patients.