M27 — July 2012 — New Way to Fix Aneurysms

Intro: Here are five words nobody wants to hear from their doctor: you have a brain aneurysm. Left untreated, aneurysms, or ballooning of blood vessels, can grow and possibly rupture, causing brain damage or even death. Treatment used to mean major surgery. But now there are less invasive options for many people. Doctors at Mayo Clinic are using a new device to repair aneurysms. It’s called a flow diverter, and it works by redirecting the blood flow away from the aneurysm. Vivien Williams reports.

Celia Serrano says the symptoms were unsettling: headaches, blurry vision and dizziness. Doctors told her they were caused by a large aneurysm in her carotid artery. Her vessel wall was bulging like a balloon.

“It measured at that point around 12 millimeters.”

Dr. Ricardo Hanel says if Celia’s aneurysm ruptured, blood would pool in her brain, causing a hemorrhagic stroke. She could suffer brain damage and even death. Because it was so big, choices for treatment were limited. Dr. Hanel could open up her brain and clip it off in a major surgical procedure. Instead, in a much less invasive procedure, he placed a new device called a flow diverter in her vessels to stop the bulging of blood.

“What we are doing is putting nothing else than a screen to change or redirect the flow away from the aneurysm.”

During the procedure, Dr. Hanel inserts a catheter and runs it up to the site of the aneurysm. There he deploys the flow diverter device. It redirects blood flow. Over the next six months, the entrance to the aneurysm becomes clotted and closed off, creating a new vessel wall.

“We are just at the beginning of experience with this device, but I expect to see over five, ten years that these aneurysms that were closed at six months, they'll remain closed for the rest of the life and they will never come back."

Right now the flow diverter device is FDA approved for aneurysms ten millimeters or larger. Dr. Hanel suspects that soon, it will be approved for smaller ones as well. Since Celia had the device placed, she’s feeling well and happy to be symptom free.

For Medical Edge, I'm Vivien Williams.

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When Celia had the flow diverter placed, she spent one day in the hospital. That is much less time than if she had had the open procedure. Both operations are effective, but for the right patient, the flow diverter offers a less invasive option.

Another less invasive option is called coiling. Doctors insert a wire into the aneurysm. It causes blot to clot and prevents blood from flowing into the aneurysms. That method of repair is also effective, but with it there is always a chance the problem could recur. Dr. Hanel says with the flow diverter there is less chance of recurrence.

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