Brain aneurysms are in essence a blister or out-pouching on a side of weakened brain vessels. With time they can grow and further weaken and burst causing subarachnoid hemorrhage. In the US, brain aneurysms afflict up to 5% of the population and about 30,000 of these patients suffer from aneurysmal rupture, which is fatal in > 40% of patients. There are only few medical centers in the U.S. that are fully equipped to diagnose and provide comprehensive treatment options for patients with unruptured aneurysms and those that present with subarachnoid hemorrhage from aneurysmal rupture.
Treatment options include microsurgical obliteration or “clipping” of the aneurysm via brain surgery where a clip is applied over the aneurysm. It’s a highly effective and well-researched procedure with excellent results for those that can tolerate brain surgery. Alternatively, brain aneurysms can also be sealed or “coiled” via a minimally invasive endovascular approach where the artery harboring the aneurysm can be accessed with consecutively small catheters via a small puncture at a groin artery. The aneurysm is then plugged with metal coils.
Endovascular treatment of aneurysms is newer technology and has been provided in the U.S. since the 80s as an excellent alternative. It is constantly being researched and advanced. In 2011, the FDA approved endovascular placement of flow diverters called Pipeline on select aneurysms. Briefly, instead of sealing the aneurysm with coils, a flow diverting stent-like material called “Pipeline” is placed within the artery harboring the aneurysm to divert blood from reaching the aneurysm. With time, there is progressively less blood flow to the aneurysm, which will eventually thrombose.
Dr. Emun Abdu has extensive training to provide both surgical (clipping, bypass) and endovascular (coiling or placement of Pipeline flow diverter) treatment options. She explains to her patients in great detail the indication to treat, and the comprehensive treatment alternatives to help her patients decide the best course of action. She is supported by neurosurgical colleagues trained and experienced in the microsurgical treatment of brain aneurysms and our neurointensivists who provide critical care for patients in our state of the art neurocritical care unit.