aneurysmcoiling

Aneurysm coiling, also known as endovascular coil embolization, is a minimally invasive procedure used to treat intracranial aneurysms. In this technique, a catheter is threaded through the vascular system to reach the aneurysm, and detachable platinum coils are deployed into the aneurysm sac. The coils promote blood clotting within the sac, creating a thrombus that helps seal the aneurysm from circulation and reduces the risk of rupture.

The procedure is typically performed via femoral or radial artery access. A guiding catheter is advanced to the cerebral circulation, a microcatheter is navigated into the aneurysm, and coils are sequentially deployed to fill the sac. In some cases, adjuncts such as stents or balloon remodeling are used to address wide-necked aneurysms or complex anatomy. The patient may be under general anesthesia or conscious sedation, depending on the case and institutional practice. Post-procedure imaging is used to assess the degree of aneurysm occlusion and to plan follow-up.

Aneurysm coiling is indicated for many saccular intracranial aneurysms, particularly those that are ruptured and at risk of rebleeding, or unruptured aneurysms considered amenable to endovascular therapy. It is generally less invasive than microsurgical clipping, though not all aneurysms are suitable for coiling. Alternatives or complementary approaches include flow diversion or microsurgical clipping, depending on anatomy and patient factors.

Outcomes vary by aneurysm size, location, and rupture status. Successful occlusion reduces rebleeding risk, but recanalization or incomplete occlusion may necessitate retreatment. Complications can include intraoperative rupture, thromboembolism, or parent vessel compromise. Recovery times are typically shorter than surgical approaches, with antiplatelet therapy required if stents are used and follow-up imaging to monitor for changes. The technique has evolved since its early development in the 1990s, with ongoing refinements in coil design and adjunct devices.