Jump to content
Search In
  • More options...
Find results that contain...
Find results in...

Hello!

By registering with us, you'll be able to view our forums in full as well as discuss, share and private message other members of Behind The Gray. Why not join us now?

pixel.gif


Endovascular Coiling


admin

If you've had an aneurysm treated by coiling you must have wondered about those coils in your head. What are they made of? How did they get there? Will they come out? Will I need more? Well I'm going to attempt to answer some of those questions here.

Firstly, My qualifications: I'm not a doctor or surgeon. Nor indeed am I a medical expert of any kind, but I suffered a brain haemorrhage in 2006 due to a ruptured aneurysm and had it treated by coiling. One of the things that concerned me when I was discharged from hospital was the lack of information about what had happened to me and how it had been treated. There are many medical articles out there on the web that deal with subarachnoid haemorrhage and coiling, but understanding the jargon can be a bit daunting, so I will try to give you the benifit of my own research and explain things in simple terms.

The Problem

The number one priority following a subarachnoid haemorrhage due to a ruptured aneurysm is prevention of re-bleeding. The traditional method is to open the skull, locate the aneurysm and place a titanium clip over the neck of the aneurysm to seal it off from the circulation. The first successful clipping was carried out in 1937, but in 1991 a new method of treatment was introduced which effectively sealed off the aneurysm from the inside. This treatment is called endovascular coiling (Endo = inside, vascular = relating to the blood vessels). Coiling has the advantage that it does not require invasive surgery and can improve recovery times. Not all aneurysms are suitable for coiling and therefore clipping is still in common use and is arguably more permanent.

The Treatment

The idea of endovascular treatment is to pack the inside of aneurysm with some kind of material to seal it off from the parent artery. Coiling consists of filling the aneurysm with fine wires which coil up inside to the shape of the aneurysm. These wires are called GDC - Guglielmi Detatchable Coils, named after their inventor.

What are the coils made from?

The coils are fine platinum wires about twice the thickness of a human hair. They are available in many different lengths and types.

gdc.jpeg

Examples of GDCs

How are they inserted?

The operation is carried out under a general anaesthetic by a neuroradiologist in a special operating theatre. Firstly, a plastic tube called a catheter is inserted into an artery in the groin and is navigated through the arteries to the brain using x-ray guidance. A contrast agent is injected into the catheter to map the arteries so they show up clearly on the x-ray screen. This part of the procedure is similar to a cerebral angiogram.

A smaller plastic tube called a micro-catheter is guided through the first catheter until it's tip is inside the aneurysm. A coil attached to a stainless steel delivery wire is fed through the micro-catheter and into the aneurysm. The coil is very soft, so as it exits the micro-catheter, it coils up inside the aneurysm. When the coil is fully deployed and the neuroradiologist is happy with the placement, a small electric current is passed through the delivery wire which detatches the coil from the end. The delivery wire is then withdrawn. Most aneurysms require more than one coil (I have four), so the procedure is repeated until the aneurysm is completely packed with coils. A final angiogram is done to make sure everything is OK and then both catheters are withdrawn.

That's it - job done! You're now fixed up ready to start your recovery.

Will they come out and will I need more coils?

It is very rare that the coils come out once inserted, but the coils can sometimes compact over time. This is usually detected during routine follow-up imaging and it may occasionally be necessary to insert more coils.

coiling.jpeg

Aneurysm prior to coiling / Coiled aneurysm

  • Like 1


User Feedback

Recommended Comments

Guest mikeymack2002

Posted

I found a great way to view my procedure, I watched the video with such concentration and found it very fascinating, I watch it often then realised just how hard the Dr's worked in surgery. They do a brilliant job for us

 

Mike

Share this comment


Link to comment
Share on other sites

hi

 

i have seen my x-rays of before and after coiling. it would be (creepily) interesting to watch the procedure.

 

My admiration goes out to everyone in volved, from the tow sets of  ambulance crews to the wonderful porters who always had a cheerful word,

Share this comment


Link to comment
Share on other sites

Not creepy at all, I found watching the video very informative and learnt that the operation was very complex and now I know just what saved my life I can smile more now knowing that what it was that happened.

 

It is amazing that such medical marvels are here to help people like us live to fight another day so to speak

Share this comment


Link to comment
Share on other sites

Where I am, our hospital offers a support group that I have attended with my husband since I was able.  They have brought in the coil suppliers, pharmacists & spiritual leaders. 

 

I have seen the coils and handled them.  All the coils are designed to turn when they leave the catheter.  We were also told that the average rupture requires approximately five coils. I thought it was one of the neatest things I have ever seen.  

 

Our group leaders have done an amazing job  letting us know what has happened, that you are not alone and that there are folks to help you deal with all of the side effects of SAH.

Share this comment


Link to comment
Share on other sites


Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Restore formatting

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


×
×
  • Create New...