Brain Aneurysm Repair
Minimally invasive treatment of ruptured and unruptured brain aneurysms using state of the art embolization techniques
Since we began working at Ascension Borgess hospital in 2013, our patients have depended on us to provide safe and effective treatment of their brain aneurysms. As one of the primary procedures we perform, this service is comprehensive, fully personalized, and administered by our highly qualified team led by Drs. Kreitel and Adix. To learn more or ask questions, simply reach out.
Types of Brain Aneurysms
Brain aneurysms occur in 1-2% of the general population. Approximately 80% of brain aneurysms are spontaneous, while 20% are caused by an underlying genetic condition and may be hereditary. They can be characterized in many ways, including by shape, size, location, and underlying cause, but they fall into 4 broad categories.
1. Saccular (most common): Balloon-like outpouching from the wall of an artery caused by focal weakness in the wall (AKA berry aneurysms)
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2. Fusiform: Diffuse dilatation of a an artery caused by weakness of the wall of the involved segment of the artery
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3. Pseudoaneurysm: Outpouching from the wall of an artery caused by a tear through 1 or more of the layers of the wall of an artery that can be traumatic or spontaneous (AKA dissecting, blister, or false aneurysms)
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4. Mycotic (least common): Outpouching from the wall an artery caused by infection or inflammation (AKA inflammatory aneurysms)
Diagnosis of Brain Aneurysms
The vast majority of brain aneurysms are discovered incidentally on diagnostic imaging of the head and neck, although some patients are initially diagnosed after the aneurysms rupture, which has a 30-40% risk of death and 20-25% risk of moderate to severe disability.
1. CTA (CT angiography): Advanced imaging technique using radiation to create high resolution image slices through the head and neck that can be reconstructed into 3D models; preferred in the acute setting because it is fast
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2. MRA (MRI angiography): Advanced imaging technique using strong magnetic fields and RF energy pulses to create high resolution image slices through the head and neck that can be reconstructed into 3D models; preferred in the non-emergent setting because it doesn't use radiation
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3. Diagnostic Cerebral Angiography: Minimally invasive image-guided surgical procedure in which a catheter is advanced from the groin or wrist to the neck, and contrast dye is injected while X-rays obtain high resolution pictures and 3D models of the blood vessels; gold standard technique for evaluating brain aneurysms
Treatments for Brain Aneurysms
Ruptured brain aneurysms are usually treated by endovascular embolization (minimally-invasive catheter-based treatment) unless it is technically impossible or too high risk, in which case surgical clipping may be considered.
Unruptured brain aneurysms are usually treated by endovascular embolization (>95% at Ascension Borgess), but surgical clipping may be considered in select cases where it is determined to be safer.
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Not all brain aneurysms need to be treated. In cases where the risk of rupture is exceedingly low or the risk of treatment outweighs the benefit, conservative management may be appropriate. Your physician will help you understand your specific situation in order to determine the best treatment for you.
Coil Embolization
A brain aneurysm with a narrow neck is filled with small metal coils to block off blood flow into it
Stent-assisted Coil Embolization
A brain aneurysm with a wide neck is filled with small metal coils, and a stent is placed across the neck of the aneurysm to hold the coils in the aneurysm
Flow Diversion
A technique used to treat wide-necked brain aneurysms in which a special stent with a tight meshwork in the wall is deployed in the parent artery across the neck of the aneurysm to divert blood flow away
Intrasaccular Flow Disruption
A technique used to treat wide-necked brain aneurysms by placing an intrasaccular device into the aneurysm, which alters blood flow into the aneurysm and leads to its closure
