Does your family have a history of aneurysms? Having a good knowledge of your family’s medical history is critical to understanding your own risk factors for developing certain medical issues. Here, we discuss aneurysms and new, low-invasive methods of treatment pioneered by interventional radiologists.
What is an Aneurysm?
An aneurysm is a localized enlargement (or “bulge”) of an artery, usually occurring at a weak spot in the arterial wall. Whilst not all aneurysms are dangerous, some have the potential to rupture, which can cause serious complications (including death).
Aneurysms are often asymptomatic. For some people, the first symptom may be rupture. Thanks to advanced medical imaging, many aneurysms are discovered by radiologists, incidentally on abdominal scans for other symptoms.
Image: 43yo lady with a splenic artery aneurysm wanting to commence IVF.
What causes aneurysms?
Smoking cigarettes is a major risk factor for the development of abdominal aneurysms. Other causes may be atherosclerosis (cholesterol plaques most common cause), infection, trauma or genetic.
Why treat an aneurysm, and who should be treated?
Due to the risk of an aneurysm rupturing, treatment is usually recommended for aneurysms larger than 2cm in diameter. In particular, aneurysms that are enlarging over time, and aneurysms in women of child-bearing age (due to increased rupture risk in pregnancy) should be treated. However, many traditional methods commonly used to treat aneurysms are invasive, requiring open surgery with prolonged hospital admission and recuperation times.
The field of interventional radiology provides a highly effective, non-invasive suite of options for treating abdominal aneurysms which result in speed of recovery, decreased pain and complications.
Coil embolisations are a common method used by interventional radiologists to treat abdominal aneurysms.
How does Coil Embolisation treat Arterial Aneurysms?
A coil embolisation is a minimally invasive treatment, which involves packing the aneurysm sac shut with a material (soft, platinum coils) that close off the sac. This can greatly reduce the risk of rebleeding or rupturing, while also allowing for a faster patient recovery time. The coils actively promote blood clotting, which ultimately works to close the aneurysm.
Coils work from inside the artery, as opposed to surgical clips, which work from outside the artery. A coil embolisation is a very effective method of preventing blood flow into the aneurysm, whilst not restricting the flow of blood through the remainder of the undamaged artery.
Benefits of Coil Embolisation
One of the most significant benefits of a coil embolisation lies in the minimally invasive nature of the operation. It is a simple procedure, and can be performed without serious discomfort to the patient. It “locks” the blood vessel, ensuring a halt to rebleeding and further damage.
Dr. Goh’s Method
Dr. Goh uses a method known as stent-assisted coil embolisation to treat abdominal aneurysms. This method allows for easier treatment of aneurysms with a wider “neck” (the point of departure from the normal arterial wall).
For most aneurysms with a wide neck, long and complex open surgery is usually required. However, Dr Goh’s method is minimally invasive. The procedure is carried out by placing a stent inside the neck of the aneurysm. The stent acts as a scaffold to preserve the parent artery and to hold the coils within the aneurysm.
The procedure is performed as a day surgery and normally takes approximately 60 minutes. A small puncture is made in the femoral artery, where the catheter is inserted and directed towards the affected artery. Then, the stent is inserted, and coils deployed into the aneurysm sac.
This effectively neuters the aneurysm whilst normal blood flow continues through the artery. The stent plays an important role, as it both holds the normal artery open and prevents the coils migrating and causing blockage issues elsewhere.
For most patients who are treated using this method, a recovery time of around several days at home is more than sufficient prior to returning to normal activities.
Coil embolisation using a stent anchor is one of the safest and most effective methods of treating abdominal aneurysms. It is rapidly gaining prominence among interventional radiologists, due to its high efficacy and low invasiveness.
Image: Splenic artery aneurysm treated with stent-assisted coil embolisation. Patient now able to commence IVF.
Get in touch!
If you are concerned about your family’s history of aneurysms, or your own personal risk, contact us here at Sydney Medical Interventions on (02) 8837 9141 to discuss your options. Due to the high fatality rate of ruptured aneurysms, it’s important to be aware of your potential to develop one and the peace of mind of knowing your treatment options.