What are the treatment options?
Patients with very small aneurysms may be monitored closely to detect any growth or onset of symptom. Each case is unique. Careful considerations are made to weigh the benefits and risks of treatment of un-ruptured aneurysms. Factors include the type, size, and location of the aneurysm, patient’s age and wish, patient’s health condition, family history and risks of treatment option.
Two options are generally available for treating brain aneurysm.
Microvascular clipping involves cutting off the flow of blood to the aneurysm surgically with a clip. Under general anesthesia, the neurosurgeon uses a microscope to locate the aneurysm and dissect it carefully. One or more clips (usually titanium) is placed on the neck of the aneurysm. It prevents blood from entering the aneurysm and removes the rupture risk. The clip remains in the patient permanently. Clipping has been shown to be highly effective. In general, aneurysms that are completely clipped surgically do not return.
Endovascular embolisation is a less invasive procedure performed by an endovascular surgeon. Once the patient has been anesthetised, the doctor inserts a catheter into a groin artery and threads it to the site of the aneurysm. Using a guide wire, detachable coils are passed through the catheter and released into the aneurysm. The coils fill the aneurysm and induce blood clot in the aneurysm. It is important to understand that the aim of surgical clipping or endovascular coiling is to secure the aneurysm to prevent future rupture or re-bleeding. The damage caused by the original rupture is still not overcome. Medical treatment of the patient continues to support recovery of any existing damage.
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