Neurointervention Basics: Cerebral Coil Embolization

The Process of Cerebral Coil Embolization

Cerebral coil embolization is a minimally invasive endovascular treatment for cerebral aneurysms. Before the surgery begins, the anesthesiologist administers general anesthesia to ensure that the patient does not experience any pain during the operation. The first step of the surgery is to perform "super-selective arterial angiography," which allows the neurointerventionalist to accurately locate the aneurysm's position, size, and shape. This step helps in adjusting the catheter and imaging equipment to fully expose the aneurysm in the doctor's field of view, preparing for the subsequent treatment.

On this basis, the doctor guides a fine microcatheter through a guide wire into the aneurysm. Once the microcatheter reaches the aneurysm sac, the doctor uses it to deliver soft metallic coils into the aneurysm. The coils form a thrombus, sealing the aneurysm and preventing blood from entering the aneurysm sac, thereby achieving a curative effect.

For different types of aneurysms, the treatment methods of cerebral coil embolization vary. For narrow-neck aneurysms, simple coil embolization can be curative; for wide-neck aneurysms, where coils might slip out, the doctor will use a stent to support the aneurysm neck to prevent the coils from entering the vessel. For some complex aneurysms, especially giant aneurysms or those with complex surrounding vascular structures, direct embolization may affect the blood supply to the brain. In such cases, doctors may opt for a "bypass" surgery, artificially connecting the surrounding vessels of the aneurysm to ensure that embolization treatment does not affect the blood supply to the brain.

Advantages of Cerebral Coil Embolization over Craniotomy

As an "interventional" surgery, cerebral coil embolization has significant minimally invasive advantages. Compared to traditional craniotomy, cerebral coil embolization does not require an incision, hence no surgical wounds or sutures, resulting in relatively minor trauma. All operations are performed inside the blood vessels, avoiding damage to brain tissue. This leads to higher postoperative comfort for the patient and a shorter hospital stay.

Due to the minor trauma, patients have shorter hospitalization periods, effectively avoiding some postoperative complications commonly seen in bedridden patients, such as lung infections, surgical wound infections, and bedsores. Therefore, cerebral coil embolization not only effectively treats aneurysms but also significantly reduces the patient’s pain and surgical risks.

Postoperative Considerations for Cerebral Coil Embolization

Although cerebral coil embolization is a minimally invasive surgery, patients still need regular follow-ups to monitor for aneurysm recurrence or other complications. Typically, patients need their first follow-up six months after discharge and may require another follow-up a year later, depending on the doctor's assessment. Regular cerebral angiography ensures the effectiveness of the treatment and timely detection of potential issues.

If the patient underwent stent-assisted embolization, they usually need to take antiplatelet aggregation medications (such as aspirin) to prevent thrombosis. It is particularly noteworthy that all current implant materials used for aneurysm embolization (including coils and stents) are not affected by common magnetic fields. Therefore, treated patients can safely undergo low-field-strength MRI examinations.