Endovascular embolization of a cerebral aneurysm

Endovascular embolization of a brain aneurysm - minimally invasive endovascular intervention, which is to exclude the aneurysm from the bloodstream of cerebral vessels using a special material (separating microspirals, stents or balloons); "Sealing" with a special adhesive composition (cyanoacrylate) or liquid plastic (polyvinyl alcohol), or overlapping microspirals of platinum.

Most often, specialists in Ukraine perform embolization of intracranial arterial aneurysms of microcoils, the essence of the method is to fill the aneurysm sac with platinum microcoils of a certain size and shape. As a result of the operation, blood does not enter the aneurysm, thus eliminating the risk of its increase and rupture.

Aneurysm of cerebral vessels is a pathological, different in shape and length local protrusion of the vessel wall of the brain. The protrusion begins to compress the surrounding brain structures, disrupting the functions of the central nervous system.

The described pathology is dangerous for the patient due to the high risk of rupture of the aneurysm with hemorrhage into the brain tissue, in the form of hemorrhagic stroke or subarachnoid hemorrhage, which leads to severe disability or even death.

Vascular aneurysms of the brain are a "slow-acting bomb", as the risk of rupture of the vessel wall is extremely high.

Today, from 600 thousand to 2 million people in Ukraine have aneurysms, about 4-12 thousand aneurysms rupture annually. The biggest problem is that cerebral vascular aneurysms affect people of working age (most often between the ages of 30 and 50).

Over the past 15-20 years, the world of surgical medicine has undergone significant changes that have allowed for serious interventions in the body without traumatic incisions. One of the revolutionary achievements in the field of vascular surgery and neurosurgery is the technique of endovascular embolization, which allows you to fight various vascular defects and diseases virtually without surgery.

If there are signs of the disease, you should immediately seek specialized medical care.

The danger of an aneurysm of the arterial wall lies in their "quiet" development. In the early stages, a person may not even realize that there is a serious problem, because small aneurysms do not compress the brain tissue and do not cause discomfort.

The clinical picture is manifested in the later stages of the disease. Pay attention to the first signs of problems that may be:

• visual disturbances, pain in the eyes and head;
• change in motor functions of the extremities - the patient may suddenly "forget" to hold a spoon or his handwriting deteriorates sharply;
• violation of tactile and pain sensitivity of the legs;
• seizures;
• numbness of the facial muscles, inability to smile, sudden violation of diction.

These signs indicate compression of brain tissue. A neurological deficit is developing, which should be the first signal and an urgent reason to seek help from the specialists of the Dobrobut Center in Kyiv.

If the disease progresses, the aneurysm may rupture. This condition is already life-threatening. Pay attention to the symptoms:

• intense headache, which is poorly amenable to medical correction;
• photophobia;
• nausea vomiting;
• double vision;
• loss of consciousness;
• intense convulsions.

If a person develops the above symptoms, an ambulance should be called immediately. If necessary, the patient will be taken to the specialists of the Medical Center "Dobrobut" for emergency highly specialized neurosurgical care.

To detect an aneurysm, a neurologist or neurosurgeon may prescribe the following instrumental examination methods:

• computed tomography (CT) - the procedure is often used to determine the rupture of a vessel with hemorrhage in the brain tissue;
• magnetic resonance imaging (MRI);
• angiography of cerebral vessels - the method allows you to assess the size, location, and structure of the aneurysm.

If a subarachnoid rupture of the aneurysm is suspected, the neurologist will also perform a lumbar puncture to assess the condition of the cerebrospinal fluid.

Endovascular embolization of the aneurysm is a minimally invasive procedure, without incisions, with a minimal rehabilitation period. The operation is performed by inserting a special "wire" into the affected vessel - a small soft metal spiral, which blocks the blood supply to the formed bag.

Endovascular methods have a number of advantages. They are minimally invasive, associated with minimal risk, and often do not require general anesthesia. Recovery time is minimal, access to hard-to-reach areas is significantly expanded.

Modern technologies of endovascular neurosurgery, performed by specialists of the medical network of Dobrobut clinics in Kyiv, make it possible to perform these operations routinely.

The catheter is a long thin plastic tube that is much smaller than a "pencil lead" or about 1/8 inch in diameter.

Spirals are of three types:

• bare platinum spirals;
• coated platinum spirals;
• biologically active spirals.

Metal stents are used to hold helices inside the aneurysm.

Spirals are made of soft platinum wire smaller than a strand of hair and are available in different diameters and lengths.

All instruments and consumables (spirals, stents, clips and everything for their implantation) are used only disposable from the best European and American manufacturers.

Before carrying out this technique of treatment the patient passes necessary researches.

At the Dobrobut Medical Center in Kyiv, you can perform all the necessary tests, undergo CT, MRI, ultrasound, radiography.

Before choosing a method of treatment, the clinic will take the necessary blood tests and prepare the patient for endovascular interventions.

A complete list of procedures will be prescribed by a doctor after the initial examination and preliminary diagnosis. Preparation for surgery may also include a special diet.

To avoid complications, our neurosurgeons use the method of computer or 3D visualization. Both methods are equally effective in cases where it is necessary to go through all the stages of the intervention step by step.

One week before endovascular embolization, the patient stops taking anti-inflammatory and anticoagulant drugs.

The patient should tell the specialists about all the medications he is taking, including herbal supplements. List any allergies, especially to local anesthetics, general anesthetics, or contrast agents.

Tell your doctor about chronic or other illnesses.

Proper diagnosis helps our neurosurgeons choose the type of procedure for aneurysms and plan interventions.

The day before the operation

• If the intervention is planned for the morning, the patient can afford a light dinner the day before.
• All prescribed medications should be taken to the hospital. Until the doctor allows, the patient should stop taking the medication. If taking these drugs is vital - report it to the neurosurgeon who operates. This is necessary for the correction of this type of therapy. The doctor will tell you when you can resume taking drugs that affect blood clotting.
• It is recommended to abstain from alcohol before the operation.
• It is strongly recommended to quit smoking to avoid life-threatening health factors.
• Take a shower before surgery.

What to do on the day of surgery?

The patient should not eat or drink anything, including chewing gum, lollipops, water, coffee, even if the procedure is performed under local anesthesia.

Contact lenses, dentures, hearing aids, and more should be removed before the operation in the ward.

Endovascular intervention is performed under local anesthesia. The duration of the operation can be short (several tens of minutes), but can also take up to several hours. The duration of the operation depends on the characteristics of the aneurysm, its location relative to vital areas of the brain, the general condition of the patient. After the operation, the patient returns to a normal lifestyle in a few hours without negative consequences for his body.

The neurosurgeon first punctures the anterior femoral surface near the inguinal ligament to access the femoral artery, and an introducer is inserted into the artery, a small elastic tube with a valve through which all other instruments are passed without injuring the artery wall. The brain aneurysm is approached with the help of very thin tubes, called microcatheters, and then, they are pushed through the blood vessels to the aneurysm inside the skull. All this time, the location of the catheter is monitored using a special X-ray machine. Sometimes at closing (embolization) of aneurysms, it is necessary to use special stents (a kind of a fine-mesh tube with cells) which interfere with an exit of spirals from a gleam of an aneurysm. Then, through the cells in the stent, the following spirals are inserted into the aneurysm.

The coils used in this procedure are made of soft platinum metal and have the shape of a spring. These spirals are very small and thin, varying in size from about twice the width of a human hair (largest) to less than one hair (smallest).

The aneurysm filled with a wire spiral is excluded from a blood groove and gradually overgrown with a connecting fabric, that is, the possibility of its rupture is excluded. At the final stage, the instruments are sequentially removed from the vascular bed, the puncture site of the femoral artery is sutured with a special device. The day after the intervention, the patient is observed in intensive care.

After surgery, the patient can expect to return home after spending one night in the intensive care unit and can expect to return to normal activities within 2 days. The doctor will provide detailed information on postoperative care before discharge from the hospital.

• Thanks to best and modern equipment and highly qualified specialists of the Medical Center can detect pathology in the early stages of development and promptly perform interventions that contribute to the successful treatment of brain aneurysms.
• Neurosurgeons working at Dobrobut Medical Center are the best specialists not only in Ukraine but also in Europe, which guarantees a successful outcome of the operation.
• Comprehensive assessment of the disease and prognosis of treatment of cerebral aneurysms.
• High level of service and balanced pricing policy in Kyiv. Loyal prices for the highest quality services.
• Our patients are always in the center of our attention, so everyone gets an individual approach and a personal coordinator who will be constantly in touch with the patient.
• All operations in MM "Dobrobut" are performed according to the protocols and in accordance with the standards of European clinics (without restrictions on the quality and quantity of consumables).

Therefore, in the fight against aneurysms, victory is always on our side.

If you have similar symptoms, we advise you to make an appointment with our specialists. Timely consultation will prevent negative consequences for your health.

You can find out details about the disease, treatment prices and make an appointment with a specialist at the Dobrobut Medical Center both on our website and by calling the call center.