Coil occlusion of cerebral aneurysms
Massachusetts General Hospital Imaging provides coil occlusion, a minimally invasive, image-guided treatment for cerebral aneurysm, in a caring environment using the latest technology.
Massachusetts General Hospital Imaging provides coil occlusion, a minimally invasive, image-guided treatment for cerebral arterial aneurysms, on the Mass General main campus in Boston. Performed by specially trained neurointerventional radiologists and endovascular neurosurgeons using real-time image guidance, interventional procedures such as coil occlusion of cerebral aneurysms are accomplished through only a tiny groin incision, may have fewer risks of complication, and take less recovery time than traditional open cerebrovascular surgery.
Coil occlusion overview
- Treats a cerebral aneurysm (a bulge in an intracranial artery as a result of weakness of the blood vessel wall) that can cause symptoms from compression of adjacent structures or from bleeding in the brain from acute rupture.
- Used in the arteries of the brain to prevent rupture to decrease the risk of hemorrhagic stroke, or to treat a ruptured cerebral aneurysm to prevent re-bleeding.
- Involves placement of a thin catheter into the aneurysm and deployment of a soft metal coil within the aneurysm to seal the aneurysm from the inside.
- The coil encourages clotting within the aneurysm and hence prevents it filling with blood, reducing the risk of rupture, or rebleeding if already ruptured.
- Requires only a 5 mm incision in the groin area, through which the Mass General specialists can access the arterial blood system.
- Takes approximately three to four hours under general anesthesia and usually requires a 48-hour admission for observation.
- As a minimally invasive procedure, the small groin incision is the only visible result of the procedure, which typically results in less recovery time than traditional open cerebrovascular surgery.
- We pay special attention to minimizing radiation exposure—without giving up image quality.
- Our state-of-the-art imaging technology plays a key role in planning and performing each procedure, and on-staff physicists and engineers ensure that our machines remain in top condition.
Coil occlusion in depth
What is coil occlusion?
Coil occlusion is an image-guided, non-surgical procedure that is used to prevent or treat bleeding arising from blood-vessel rupture due to a cerebral aneurysm (a bulge or sac in an artery wall). The procedure involves threading a thin catheter through your blood vessels to the point of the aneurysm and placing one or more soft metal coils within the aneurysm. Once the coils are in place, your blood will clot around them, blocking off the neck of the aneurysm and restoring a normal pathway of blood flow. This procedure is generally performed under general anesthesia.
The neurointerventional team who perform procedures at Mass General Imaging are specialists in the area of the body and the condition under treatment, as well as the procedure itself. These specialists have all undergone additional education, plus have extensive real-world experience. In many cases, our doctors helped to pioneer the interventional treatments that we offer.
Our team of specialist physicians and nurse practitioners coordinates a patient's complete care—from imaging evaluation to post-procedure followup—maintaining a high level of communication with the patient throughout the process. In addition, Mass General Imaging works in close coordination with experts from across Mass General when necessary, to ensure the best patient outcomes.
What should I expect BEFORE coil occlusion?
- Pre-admission testing: We will schedule an appointment for you. Because your procedure uses contrast dye, we need to know whether you are allergic to any contrast, and a blood test may be required to check elements of your body chemistry. You will also see an Anesthesiologist at Mass General to assess your cardiovascular status prior to general anesthesia.
- Food and drink: You must not eat solid foods, candy, gum, or drink liquids after midnight on the night before the procedure (this will reduce your risk from the anesthesia). Your procedure may be canceled if you do.
- Medications: It is important to tell us the names of any medications you are taking in advance of your procedure. You may need to stop taking or change certain medications. In addition, you may be prescribed medication for you to take a few days before the procedure.
- When to arrive: Two hours prior to the procedure.
- Preparation: A nurse will insert an intravenous (IV) line. You will be attached to a cardiac and blood pressure monitor prior to receiving general anesthesia by the Mass General Anesthetic team. You will be given a catheter to collect your urine, and the incision area in the groin will be cleaned and shaved.
What should I expect DURING coil occlusion?
Since the procedure is performed under general anesthesia, you will be completely asleep for the entire duration. During the procedure, a specially trained NeuroInterventional radiologist or Endovascular Neurosurgeon uses live imaging to thread a plastic tube, called a catheter, through your blood vessels from a small incision in the groin to the location of the cerebral aneurysm. The doctor then places one or more tiny metal coils into the aneurysm. Once the coiling is complete, you will awake in the recovery area where a team of specially trained doctors and nurses continue to monitor your care.
What should I expect AFTER coil occlusion?
If your procedure treated a ruptured cerebral aneurysm in progress, you will remain in the hospital for as long as necessary to recover. If your procedure was done as a preventative measure, you will be admitted to the hospital for 48 hours so that we can monitor your condition. Once you return home, you should take it easy for a few days and avoid any strenuous activity for 10 days. Most people return to a normal level of activity in one to three weeks.
Department of Radiology Chairman Emeritus James H. Thrall, MD, explains how the ability to see deep inside the body has driven the development of minimally invasive methods of treatment—a trend in which Mass General Imaging has played a key role.
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