Aneurysm Treatments

An aneurysm is an enlargement of a weak area of a blood vessel. The pressure of blood flow can cause the weakened area to enlarge like a balloon far beyond the normal diameter of the vessel. Because aneurysms can burst or rupture, they are a serious health condition; aneurysms in the brain (cerebral aneurysm) can cause headaches, strokes, or fatal bleeding.

Depending on the status of the patient's health and other factors, physicians may choose to treat an aneurysm to prevent rupture. A ruptured aneurysm is a medical emergency and is treated in the intensive care unit.

Aneurysms can be treated from outside the brain, in a surgical procedure, or from inside, in an endovascular procedure. Physicians may combine surgical and endovascular techniques to treat an aneurysm.

WHEN IS IT INDICATED?

Aneurysm treatment is usually performed to manage an aneurysm that has not yet ruptured, called elective treatment. Aneurysm surgery is also done in emergency situations when a person arrives at a hospital soon after a rupture has occurred.

PRE-TREATMENT GUIDELINES

Before performing surgery, physicians assess the extent, size, and exact location of an aneurysm using imaging tests, such as computed tomography (CT) scan and magnetic resonance imaging (MRI).

RISK FACTORS FOR POSSIBLE COMPLICATIONS

Risk factors for possible complications from aneurysm treatment include advanced age; serious disease such as cancer, heart disease, or kidney disease; and hypertension.

WHAT TO EXPECT

The treatment strategy for each aneurysm is developed for individual patients based on factors such as the aneurysm's size, location, and estimated risk of rupture. The goal of aneurysm treatment is to prevent blood from flowing to the aneurysm so it cannot bleed.

Surgery. To access and repair an aneurysm, the physician makes an incision in the scalp above the aneurysm. Next, the physician cuts into the skull and removes a small flap of bone to expose the aneurysm. Then the physician clips or clamps the aneurysm where it emerges from the wall of the vessel.

Endovascular treatment. The physician inserts a catheter in the groin and threads it through the blood vessels until it reaches the aneurysm in the brain. Then the coils are pushed through the catheter into the aneurysm and detached. The coils fill the aneurysm so that blood cannot enter the aneurysm and cause it to rupture.

POSSIBLE COMPLICATIONS

Surgical complications vary depending on the characteristics of the aneurysm and a person's age and physical condition. Serious complications include brain damage and death (rare).

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