HealthSheets™

Adhering to the principles of health literacy, this extensive library of evidence-based, peer-reviewed information was written specifically for patients and covers diseases and conditions, diagnosis and treatments, surgeries and procedures, and wellness and safety for people of all ages and walks of life.

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Aneurysm Treatments

Aneurysms are weak spots in the blood vessel. The blood vessels could burst because they are stretched too thin.

Most aneurysms occur where an artery branches. Treatment options vary. It depends on the type of aneurysm, its size and location.

The goal of aneurysm treatment is to prevent it from bursting or bleeding again. This is done by sealing off the aneurysm from the artery out of which it grew.

You may need a surgical clip or endovascular coiling right away. This is if an aneurysm is the cause of your hemorrhagic stroke.

Your doctor may also recommend clipping, coiling or a flow diverting stent if your aneurysm has not burst but may be at risk of rupture.

Your doctor will talk about these treatment options with you. He will recommend the best treatment for you based on:

Your age
Your risk factors
Size of your aneurysm
Your overall health

Surgical Clipping

Surgical clipping is now less common. It was the only option for wide-neck aneurysms. It is used more for aneurysms that have burst. The surgery can be done for both a narrow or wide-neck aneurysm.

Your surgeon locates the blood vessel with the aneurysm. He or she removes a piece of skull to place a metal clip across the base of the aneurysm. The clip cuts off the blood flow to the aneurysm. This lowers the risk your aneurysm could burst in the future.

Coiling

Endovascular Coiling

The more common treatment for most brain aneurysms now is endovascular coiling. It has better clinical outcomes. It is also less invasive.

For endovascular coiling a small incision is made in your groin. Small tubes and wires travel through your blood vessels to the aneurysm in your brain. Tiny, soft metal coils are pushed through the tube and placed in the aneurysm.

The coils compact to create a tiny metal ball. This helps prevent blood flow from entering the aneurysm. It will relieve the pressure that pushes against the walls of the aneurysm. Your doctor will decide on the size and number of coils needed for your aneurysm.

Coils enter and fill the aneurysm

A narrow neck aneurysm is treated with coils that divert blood flow away from weak vessel walls. A wide neck aneurysm needs special attention. Coils alone don't stay in place because the openings are so wide.

Stent Assisted Coiling

This is a non-surgical option for wide neck aneurysms. Your doctors make a small incision in your groin to insert a tiny tube into a main artery in your leg. With the help of X-ray scanners, they then weave the tube up through your blood vessel to the site of the aneurysm in your brain.

The tiny tube is called a stent. The tube is hollow metal with holes in it. This allows the coils to fill in the aneurysm.

The stent acts as scaffolding. It secures the coils in place and keeps them from falling out. Over time, natural healing occurs and blood clots on the coils. This diverts blood away from the weakened vessel walls and prevents a rupture.

Stent-assisted coiling

Your doctor may use a balloon or an open metal tube called a stent if your aneurysm has a large opening. This is known as a wide neck aneurysm. These devices help keep the coils in place inside the aneurysm.

Balloon-assisted coiling keeps the coils in place with a removable balloon where the aneurysm branches off the artery.

Balloon-assisted coiling

Benefits of the stent-assisted coiling

A key benefit is that you don’t need surgery. There will be less stress on your body and you can recover much more quickly. Most people spend only a couple of nights in the hospital after a stent procedure. They return to work in a week or so.

What are the risks of the procedure?

The coils could block your carotid artery or smaller blood vessel if for some reason they become loose. This would cause a stroke. Placing the stent across the neck of the aneurysm makes this very unlikely.

Your doctor will talk with you about your treatment options for a brain aneurysm. Please be sure to ask to your health care team any questions you may have.

Your doctors can also use a flow diverting stent to go around the aneurysm or to hold the coils in place. A flow diverting stent is more mesh-like and has smaller holes.

Flow Diverter Stent

Your doctor may use a flow diverter stent to treat brain aneurysms that have not burst. Your doctors make a small incision in your groin to insert a tiny tube into a main artery in your leg.

Flow diverting stents are more mesh-like, with much smaller holes. This type of stent is made to lessen or re-direct blood flow away from your aneurysm. This may lower the risk of your aneurysm bursting.

Flow diverting stents are another option other than coiling to treat aneurysms that have not burst. Your doctor will decide the best treatment for you.

Questions

Your health care team will talk about these aneurysm treatment with you. They will explain your type of aneurysm. Please ask your health care team any questions you may have.