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Home > Neuroscience Institute 

NeuroScience Institute

Aneurysm

Mercy Health Center was the first facility in Oklahoma to treat patients with wide-necked aneurysms without performing brain surgery. A much less invasive procedure than a craniotomy, it can be done in about 60 percent of cerebral aneurysms. 

In Oklahoma, Mercy interventional neuroradiologists, Dr. Timothy Tytle, Dr. Vance McCollom and Dr. Robert Handley, are pioneers in performing this major, non-operative treatment breakthrough. 

What is an aneurysm?

Similar to the bubble that can occur on a car's rubber tire, an aneurysm is an outward swelling of the wall of an artery that occurs due to weakness in the arterial wall. Most patients have no symptoms or complaints until the aneurysm ruptures. However, about 40 percent of cases have warning signs including:

  • pain above and behind the eye

  • nerve paralysis

  • localized headache

  • neck pain

  • nausea 

  • vomiting
     

What are the causes?

Aneurysms are often caused by the normal aging of arteries, but growth can also be caused by smoking, high blood pressure, kidney disease and connective tissue disorders. Aneurysms can also be hereditary. 

Because an aneurysm may continue to increase in size, along with progressive weakening of the artery wall, surgery may be needed. Preventing rupture of an aneurysm is one of the goals of therapy. The larger an aneurysm becomes, the greater the risk. 

There are two primary treatments for a cerebral aneurysm:

Craniotomy – In about 40 percent of cases, brain surgery with surgical clipping is necessary. A Mercy neurosurgeon exposes the aneurysm and places a metal clip across the neck of the aneurysm, preventing blood flow into the aneurysm sac. 

Endovascular coiling or coil embolization -- Endovascular coiling is a procedure in which a catheter is advanced using fluoroscopy -- similar to an x-ray “movie” -- from a blood vessel in the groin up into the blood vessels in the brain. Once the catheter is in place, tiny platinum coils (or “enterprise stent”) are advanced through the catheter into the aneurysm, conforming to the shape of the aneurysm. The coiled aneurysm becomes clotted off (embolization), preventing rupture. This means that instead of weeks of recovery, the patient leaves the hospital a day later. The entire procedure take an hour or two.

Mercy places first stent designed for the brain

Mercy now treats more than 100 brain aneurysms each year. Even one of the most difficult aneurysms to treat - a wide-necked aneurysm - can now be treated with a less invasive procedure that places a stent at the area of the aneurysm with a catheter. Once the stent is in place, metallic coils are placed inside the aneurysm to decrease the chance the aneurysm will rupture.

Stent caption above.
©2007 Boston Scientific Corporation or its affiliates. All rights reserved. Neurofom3® Microdelivery Stent System is a Humanitarian Device authorized by Federal law for use with embolic coils for the treatment of wide-neck, intracranial, saccular aneurysms arising from a parent vessel with a diameter of >2 mm and <4.5 mm that are not amenable to treatment with surgical clipping. Wide-neck aneurysms are defined as having a neck > 4 mm or a dome-to-neck ratio < 2. The effectiveness of this device for this use has not been demonstrated.

 

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