University of Rochester Medical Center Offers Multiple Options for Cerebral Aneurysm Patients

January 11, 2000

For patients with certain types of cerebral aneurysms, the University of Rochester Medical Center's Strong Memorial Hospital offers the choice of two treatment options.

Brain aneurysms, which are more common in women than in men, result from increased pressure on weakened blood vessel walls. While no one factor has been identified as the sole cause, gender, heredity, age, high blood pressure, and various connective tissue disorders appear to play contributing roles in aneurysm development. In the United States each year, nearly 40,000 individuals are diagnosed with a cerebral aneurysm and about 40% of those with a cerebral hemorrhage will die within the first three months after rupture.

For the last several decades, the standard approach to treating both ruptured and unruptured cerebral aneurysms has been surgical clipping - brain surgery to "clip" and repair the abnormal blood vessel. This treatment has been proven effective for the majority of patients who have both ruptured and unruptured cerebral aneurysms. Often times, due to the aneurysm's size, its position, its configuration, and the patient's medical condition, surgical clipping is often the best mode of treatment.

"Ruptured cerebral aneurysms can exact a terrible toll on patients and their loved ones," says neurosurgeon Cargill Alleyne, M.D. "With modern microsurgical techniques, these weak spots can be repaired, thus eliminating the chance of rerupture and potentially improving outcome. "

While clipping remains a very effective treatment, for patients who suffer high-risk aneurysms deep inside the brain, or for those in a poor neurological state, an alternative, minimally-invasive method is providing renewed hope. The Guglielmi Detachable Coil (GDC) technique, the first device of its kind approved by the FDA, has become an alternative method for treating cerebral aneurysms which carry a high risk of morbidity and mortality.

Through a series of soft catheters inserted into the patient's femoral artery, surgeons deliver platinum microcoils to the brain aneurysm, release the coils into place, and detach them from the catheter by applying a very low voltage electrical current. The coils fill the aneurysm, isolating it from circulation, and reducing the likelihood of a future rupture or hemorrhagic stroke.

GDC is usually performed under general anesthesia and length of stay is typically a few days for patients with unruptured aneurysms. For those with ruptured aneurysms, the stay is longer.

Strong's highly-specialized team led by Alleyne and neuroradiologist Yuji Numaguchi, M.D., Ph.D., is unique in that this team has the expertise to treat aneurysm patients through both surgical and non-surgical intervention.

Of the thousands of cerebral aneurysm diagnoses each year, approximately 25% of these cases are inoperable due to the aneurysm's location, its anatomy, or the patient's medical condition. The GDC procedure gives such patients the chance for complete recovery. Because of the increasingly widespread use of coiling over the last few years, indications for treatment have been extended to include certain types of unruptured aneurysms and also to ruptured aneurysms in the elderly or very ill.

"Detachable coil embolization is an exciting new treatment for patients with aneurysms which cannot be treated surgically," says Numaguchi, professor in the Department of Radiology at the University of Rochester Medical Center's Strong Memorial Hospital. "We are pleased that we are able to offer patients this alternative treatment."

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