Interventional Neuroradiological Procedures for Coiling and Embolization of Aneurysms and Other Neurovascular Lesions
Coiling is performed by neurointerventional specialists who have expertise in treating conditions in the brain by endovascular (through the blood vessel) means. The procedure is accomplished with a catheter that is inserted into the groin and threaded up through the arteries directly to the problem site in the brain. Coils, or mesh wires, are inserted into the aneurysm to prevent the space from filling with blood and rupturing. Coiling was perfected by American-based neuroradiologist Guido Guglielmi, M.D., as detachable coils. Since Food and Drug Administration approval in 1995, coils have revolutionized endovascular treatment of cerebral aneurysms.
Embolization of brain aneurysms is a minimally invasive treatment for aneurysms and other blood vessel malformations (fistulas) that occur in the brain. An aneurysm is a blister-like bulge that develops in an artery because the vessel wall is weak. A bulging aneurysm in the brain may compress surrounding nerves and brain tissue resulting in nerve paralysis, headache, neck ache, neck or upper back pain as well as nausea and vomiting. If a brain aneurysm ruptures, internal bleeding can cause a stroke or death.
In embolization, surgeons use image guidance to perform coiling (described above) at the site of the bulge or passageway, where it helps block the flow of blood and prevents a rupture of the vessel.
Embolization has become a sophisticated treatment option used for a variety of neurological diseases involving blood vessels and tumors. It can close abnormal vessels and aneurysms in the brain, face and neck. It is most often used in combination with other treatment methods, such as radiosurgery or neurosurgery, although it can be curative for certain problems. In some cases, embolization is beginning to replace surgery in the treatment of various complex cerebrovascular procedures.