Type of Surgery
Last updated: 11/24/2009
A promising new alternative to open surgery is the use of inventional neuroradiology to treat aneurysms. The greatest advantages to this technique are that it is less invasive and requires less recovery time in most patients. This technique is also...
more effective than craniotomy for certain positions of aneurysms or for patients that have complicating conditions that would make them unable to tolerate the stress of the more traditional surgery. The decision of whether an aneurysm should be treated surgically with a clip or through inventional neuroradiological techniques should be made as a team by the neurosurgeon and the endovascular radiologist.
Inventional neuroradiology, also known as endovascular neuroradiology, utilizes fluoroscopic angiography, described as a diagnostic imaging technique. Besides delivering the contrast material, the catheter can be used to place small coils, known as Gugliemlimi detachable coils, within the neck of the aneurysm using a delivery wire. Once the coil has been maneuvered into place, an electrical charge is sent through the delivery wire. This charge disintegrates the stainless steel of the coil, separating it from the delivery wire, which is removed from the body, leaving the coil. Anywhere from one to 30 coils may be necessary to block the neck of the aneurysm from the normal circulation and obliterate it, as occurs with the clip procedure. Although more research is needed to compare the two procedures, recent results indicate that intervention surgery for ruptured aneurysms may be safer than the traditionally more invasive procedure and may increase the chances of survival without disability after SAH.
An artist's representation of what nerves and nerve bundles look like at the microscopic level. It also shows how the anatomy of a nerve allows it to transmit electrical signals and communicate with other neurons (nerves).
Cerebral aneurysm repair involves corrective treatment of an abnormal blood-filled sac formed by localized expansion of an artery or vein within the brain. These sacs tend to form at the juncture between a primary vessel and a branch. If the vessel involved is an artery, the lesion is also known as a berry aneurysm because of its round, berry-like appearance.
The purpose of the surgical treatment of cerebral aneurysms is to isolate the weakened vessel area from the blood supply. This is commonly done through the strategic placement of small, surgical clips to the neck of the lesion. Thus, the aneurysm becomes isolated from the normal circulation without damaging adjacent vessels or their branches and shrinks in size to become undetectable, a process known as aneurysm obliteration.
Select comparative data from 1999 to 2006 include a decrease of 14 percent in the number of neurosurgeons in private practice and a decrease of 13 percent in the number of neurosurgeons in solo practice.
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