Endovascular treatment is a minimally invasive method for diagnosing and treating patients from within the blood vessel. In the case of cerebral aneurysms, this treatment is called coil embolization or "coil".
The treatment of detachable coils embolization does not require open surgery. Instead, doctors use real-time X-ray technology called fluoroscopy imaging to visualize the patient's vascular system and treat diseases from inside the blood vessels.
Coiling involves inserting a catheter into the femoral artery of the patient's leg and guiding the catheter through the vascular system into the patient's head and to the aneurysm. The entire process is completed through using continuous X-ray visualization and high-speed radiography.
Once the doctor detects the presence, size, and location of the aneurysm, a "microcatheter" will be placed in the initial catheter. When the microcatheter successfully enters the opening of the aneurysm, the embolic coil system can be introduced.
The platinum coil is deposited in the aneurysm for reducing or preventing blood flow to the aneurysm. The detachable coils are made of platinum, so they can be seen through X-rays and are flexible enough to conform to the shape of the aneurysm. The purpose of coiling is to tightly wrap the aneurysm to prevent blood flow to the aneurysm and prevent it from rupturing.
Once it is placed in the aneurysm, a small current passes through the wire. Due to this electrolysis, the detachable coil is separated from the wire and remains in the aneurysm.
After the aneurysm is packed, the catheter is removed, and the patient will be transferred to the intensive care unit for monitoring and further care. The treatment process is carried out under general anesthesia.
Patients who have completed the coiling operation before the aneurysm ruptures can be monitored overnight in the intensive care unit. Usually, they will not feel pain or have scars remained from the operation.
Patients with a ruptured aneurysm stay in the intensive care unit for a longer time, usually 10 to 14 days.
When a patient is diagnosed with a cerebral aneurysm, time is of the essence. After the first rupture of an aneurysm, there is a 50% mortality and morbidity; after the second rupture, this rate increases to 75%.
In addition, studies have shown that for patients who are both suitable for open surgery and coil embolization, intravascular detachable coil embolization has a significantly better prognosis than surgery in terms of one-year disability-free survival rate.
The relative risk of death or severe disability after one year of embolization coil therapy was 22.6% lower than that of patients who received surgery.