New Non-surgical Approach Showing Great Promise In The Treatment Of Challenging Brain Aneurysms

A second opinion brought Collins to Rush UniversityMedical Center and Chicago Institute of Neurosurgery and Neuroresearch(CINN) neuroendovascular specialist Dr. Demetrius Lopes. Lopesrecommended a new approach combining the use of intracranial stents andcoil embolization to strengthen the artery with no need to open theskull. Dr. Lopes is one of the most experienced physicians in the worldwith this new technique.

"Obviously, why would I want to undergoa long recovery period if I don't have to," said Collins. "I chose tohave Dr. Lopes perform the procedure and it was a complete success. Iwas back on the golf course within days."

Until recently, peoplelike Collins with wide-necked aneurysms in the brain would not havebeen candidates for coil embolization, a procedure in which tiny coilsare used to close off the aneurysm. To deliver the coils to theaneurysm, a catheter is inserted into the femoral artery, located inthe upper leg, and threaded through the artery and into the bloodvessels of the brain.

Historically, if the aneurysm was more than4mm, the "wide neck" of the aneurysm prevented the coil from staying inplace on its own and the aneurysm was very likely to return. The recentintroduction of flexible intracranial stents has provided a method ofpreventing the coil from migrating out of wide-necked aneurysms.Therefore, more patients can undergo minimally invasive interventionsto repair their cerebral aneurysms.

The initial treatment stageinvolves placement of the stent in the artery across the aneurysm neck.A microcathether is navigated through the stent struts into theaneurysm sac. The second stage consists of filling the aneurysm withcoils. The stent works as a scaffold preventing the coils frommigrating out of the wide neck aneurysm. The body responds by forming ablood clot around the coils and new tissue growth around the stentstrengthening the weak spot in the artery.

A study by Lopes,published in the January issue of the Journal of Neurosurgery, foundthat in 90 percent of his patients, the stent-assisted coil resulted incomplete closure of the aneurysm without compromising the parent vesselat least six months after the procedure.

"Our results areencouraging because they demonstrate that devices like the intracranialstent will continue to not only improve our ability to treatchallenging wide-necked aneurysms without opening the skull but also tohave a significant impact on re-treatment rates" said Lopes.

Coilembolization is currently used to treat approximately 30 percent ofcerebral aneurysms. The procedure is less invasive and requiressignificantly less recovery time than open surgery for aneurysm repair.Additional benefits include minimal blood loss and the option for localanesthesia. Patients who did not have a ruptured aneurysm prior totreatment may be able to leave the hospital the day after the procedureand return to their normal routine within days.

Collins returnedto the hospital four months after his procedure for additional tests tomake sure there was no leakage. The results showed the stent-assistedcoil embolization was a success.

"I am very pleased with the results," said Collins. "I have no limits and I'm enjoying life to it's fullest."

RushUniversity Medical Center is an academic medical center thatencompasses the 600 staffed-bed hospital (including Rush Children'sHospital), the Johnston R. Bowman Health Center and Rush University.Rush University, with more than 1,270 students, is home to one of thefirst medical schools in the Midwest, and one of the nation'stop-ranked nursing colleges. Rush University also offers graduateprograms in allied health and the basic sciences. Rush is noted forbringing together clinical care and research to address major healthproblems, including arthritis and orthopedic disorders, cancer, heartdisease, mental illness, neurological disorders and diseases associatedwith aging.

The Chicago Institute of Neurosurgery andNeuroresearch is one of the nation's leading organizations for thediagnosis, treatment and rehabilitation of people with brain and spinedisorders. Originally founded in 1987, CINN is the Midwest's largestteam of neurosurgeons known for their pioneering treatments inminimally invasive techniques. Through a network of seven hospitalsspanning two states, CINN treats more patients with brain tumors andspine disorders than any other physician group in Illinois.