Brain aneurysm’s survival rate has increased rapidly because of today’s advancements in the field of medicine and technology.
In the old days, once you are diagnosed of having brain aneurysm, it is akin to being given a deadline on your life. Way back in the past, the treatment for brain aneurysm is considered to be stuff of which movies are made of. Now, all those that they have imagined and visualized are within reach. The survivability of people having brain aneurysm has increased by leaps and bounds, and we have the guys at the lab to thank for. In this article, let us look into some of the most common treatment procedures employed to help patients diagnosed of having a brain aneurysm.
The traditional way of handling brain aneurysms would be though a craniotomy. A craniotomy involves surgically removing a part of the skull in order to reach the tissues protected below – in this case, the affected blood vessel. This is a high risk operation, as you may very well deem. At this point, let us assume that the aneurysm has not yet ruptured. Once a portion of the skull has been opened, the doctors will be attaching a metal clip on the “neck” of the aneurysm, effectively cutting off blood flow into the area. This is called “clipping” and is considered to be one of the most popular and the most common methods of aneurysm treatment. This method stops the aneurysm from getting any bigger, preventing any risk for rupture. Through time, the aneurysm will eventually shrink and form a scar.
One thing to remember with clipping is that the clip used is metallic. This might give you a hard time when passing through metal detectors and undergoing MRI procedures. It is best to ask your doctor if your metal coil is MR compatible or not.
Nowadays, it has been found that a craniotomy is usually no longer needed when treating brain aneurysms. The following paragraphs will be about some of the most innovative procedures being performed on patients with brain aneurysms.
Occluding and Bypassing
In instances where the aneurysm is too big and too fragile to clip, the occlusion and bypass method is used. In this surgical procedure, entry into the affected vessel is made through a craniotomy since grafting will be done. During the procedure, the blood flow into the affected area is literally stopped and the blood is rerouted by attaching another artery to that very same arterial line. This new artery is usually taken from the leg and is grafted into the area, making it like a detour for the blood. Once the procedure is done, blood will no longer flow through the aneurysm because it will be passing through the newly grafted blood vessel.
Another method for treatment of aneurysms is with the use of metal coils. This is called endovascular embolization. In this procedure, the doctor will have his patient undergo an imaging procedure to visualize the area with the out pouching. Once the area has been visualized, the surgeon will be using a tiny catheter that will be injecting a contrast dye into the area in order to accurately detect where he is going. Continuous x-ray visualization is used to determine the location of the catheter and its distance from the aneurysm itself. With today’s technology, they use real time viewing, thus exposure to x-ray radiation is lessened.
Once the area has been properly visualized, a smaller catheter containing the wire coil will be inserted inside the first catheter. This smaller catheter will contain the platinum coils that will be used to fill the aneurysm, thus effectively blocking further blood flow into the area.
In some instances, the “neck” of the aneurysm may be too wide, causing the coils to loosen over time and maybe unravel into the artery. This may prove to be very dangerous, thus stenting is developed.
The stent is like a wire mesh placed within the wall of the artery, effectively blocking the opening at the “neck” of the aneurysm. The proper name for it would be intracranial stent. It is usually made from an alloy of nickel and titanium.
Once you have a stent in place, your doctor would probably place you in anticoagulant therapy because having a stent places you ate great risk for developing intracranial blood clots.
Lately, newer technology has been developed that can rival that of coils. It is with the use of liquid embolics, and in the United Stated, this miracle liquid is called Onyx HD 500. The Onyx HD 500 is a form of glue that turns solid once it comes in contact with blood.
After visualization procedures have been performed, the surgeon will be inserting a balloon catheter into the area, blocking the neck of the aneurysm. Once the balloon catheter is in place, the glue will be injected into the out pouching. Intermittently, the balloon will be deflated to allow the passage of blood, but it will not be removed until the glue has properly solidified and is securely in place. If you look at it in a certain way, it is like turning blood into cement, thus blocking any blood flow into the aneurysm.
As you can see from the treatment methods mentioned above, patients with brain aneurysm have now a greater chance for survival as compared to the years before. There is even an intra-nasal entry that is currently being researched on. This lessens the invasiveness of brain aneurysm treatments. I am sure this is good news to everyone, surgeons and patients alike.
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