Every 18 minutes, someone in the United States experiences a ruptured brain aneurysm. And with one in 50 Americans living with an unruptured aneurysm right now, you never know when it could be you next.
A brain aneurysm is a weak, balloon-like bulge in the wall of an artery in the brain, and most do not cause symptoms until they leak or rupture. About half of those ruptures turn fatal, but getting a brain aneurysm embolization greatly increases survival rates.
Read on to learn what happens before, during, and after a brain aneurysm embolization, and where to find the best brain aneurysm surgeon in Los Angeles for treatment.
How Does a Brain Aneurysm Embolization Work?
A brain aneurysm embolization closes off the weak spot in your artery from the inside, using small tools threaded through a blood vessel. This procedure is also called an
endovascular coiling when platinum coils are used for sealing.
During the procedure, the arteries are accessed through a small puncture, usually in the groin or the wrist, which means no incision in the skull and no need to move brain tissue out of the way.
Who is a Good Candidate for a Brain Aneurysm Embolization?
Deciding which brain aneurysm treatment is right for you is a decision only a neurosurgeon can make. To plan your treatment, they will study the size, shape, location, and neck width of the aneurysm, as well as your age, blood pressure, smoking history, and family history of brain aneurysms.
Ruptured aneurysms are treated as emergencies to stop the bleeding and reduce pressure inside the skull. Unruptured aneurysms may be treated to prevent a future bleed, especially if they are growing or sit in a high-risk part of the brain.
How to Prepare for Brain Aneurysm Embolization
Preparing for this procedure includes getting a cerebral angiogram, CT angiography, or MRA. Additionally, your surgical team will want to do blood work and an EKG to confirm you are healthy enough for general anesthesia.
Factors that can affect your surgical team’s decisions include:
- Being pregnant or breastfeeding
- An allergy to contrast dye, iodine, or shellfish
- Certain medications, like blood thinners, aspirin, or some herbal products
- A history of asthma, diabetes, kidney disease, or heart conditions
Before surgery, most patients are told to stop eating and drinking after midnight the night before. You should also leave jewelry, contact lenses, and metal objects at home, and wear loose, comfortable clothes. Arrange for a family member or friend to drive you home and stay with you for the first 24 hours, since the anesthesia and sedatives can leave you tired and unsteady for the rest of the day.
What Happens During a Brain Aneurysm Embolization Procedure?
When you arrive at the hospital, the surgical team starts an IV, attaches monitors for your heart rate and blood pressure, and administers general anesthesia in most cases. You will be asleep and feel nothing during the procedure. The best neurosurgeon in Los Angeles will start by making a small puncture in the femoral artery in your groin, or sometimes the radial artery in your wrist, and insert a thin catheter. A larger guide catheter goes in first, and smaller catheters slide through it like a series of nested straws.
During the procedure, the doctor watches a live X-ray, called fluoroscopy, on a screen above the table and injects a contrast dye that highlights the blood vessels in real time. The catheter travels up through the aorta, into the neck arteries, and into the brain arteries. At the aneurysm itself, an even smaller microcatheter is threaded into the bulge so the team can deliver treatment right where it is needed.
The actual sealing of the aneurysm takes patience and precision. Platinum coils are pushed through the microcatheter, one at a time, until the sac is packed full and blood can no longer flow within. Some cases call for a flow-diverting stent placed across the parent artery, and others use a liquid embolic agent that hardens into a glue-like plug. Most procedures take one to three hours. Before closing, the doctor runs a final angiogram to confirm the aneurysm is sealed.
Brain Aneurysm Embolization Risks, Side Effects, and Complications
The most common side effects are bruising, soreness, or minor bleeding at the catheter site in the groin or wrist. Some patients have a mild headache afterward, or a short-term reaction to the contrast dye, such as nausea, warmth, or itching. Infection is rare, with rates requiring antibiotic treatment reported at less than one in 1,000.
Brain Aneurysm Embolization Recovery Time
You’ll spend the first few hours after the procedure in recovery, where you will be closely watched. Typically, you will lie flat for four to six hours so the puncture site can seal properly. Nurses will check your pulse, blood pressure, and neurological signs during your recovery period. Most patients move to an ICU or step-down unit for overnight monitoring. A hospital stay of one to three days is typical for an unruptured aneurysm. Ruptured aneurysms usually require a longer stay, often one to four weeks, depending on the level of brain injury from the original bleed.
At home, for the first one to two weeks, doctors usually recommend no heavy lifting, no strenuous exercise, and no driving while you are on certain pain or sedating medications. Most patients return to desk work and light daily activity within a few days of discharge, and most return to full activity within two weeks.
Brain Aneurysm Embolization Success Rate and Long-Term Outcomes
Long-term outcomes for brain aneurysm embolization are excellent, especially when the aneurysm is small with a narrow neck. More than 80% of aneurysms treated with coil embolization remain permanently sealed at long-term follow-up. Newer tools such as flow-diverting stents and stent-assisted coiling have pushed those numbers higher for many wide-necked and complex aneurysms that were once considered hard to treat.
Finding the Best Brain Aneurysm Specialist in Los Angeles for Minimally Invasive Embolization
A brain aneurysm diagnosis is a heavy thing to carry, and choosing the right surgeon is one of the most important steps you can take next. Dr. Yashar is a board-certified, fellowship-trained neurosurgeon in Los Angeles with deep training in brain aneurysm embolization and other neuro-interventional procedures. Our team treats a full range of brain, spine, and neuro-interventional conditions, with a focus on the careful precision required for brain aneurysm embolization.
Ready to get the most advanced brain aneurysm treatment available from the best neurosurgeon in Los Angeles?
