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Endovascular Coiling

Medical Author: Danette C. Taylor, DO, MS, FACN

Danette C. Taylor, DO, MS, FACN

Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.
Medical Editor: Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Endovascular coiling vs. surgical clipping

Surgical clipping has been around for longer than endovascular coiling, and there is some data that suggests that the clipping procedure is less likely to require a repeat procedure over time. However, a study performed in 2002 looking at open surgical clipping vs. endovascular coiling as treatment for ruptured aneurysms (the International Subarachnoid Aneurysm Trial, or ISAT) was stopped early as the rates of associated disability or death after 1 year were much less in the group which was selected to receive endovascular coiling.

However, since that time, surgical approaches have changed; surgeons now make very small incisions to access the aneurysm, which decreases disability and length of hospitalization even for the surgical clipping. Additionally, there have been no studies comparing the two types of procedures for unruptured aneurysms. Evaluation of the data collected for both types of procedures suggests that patients who undergo endovascular coiling have shorter hospital stays, fewer complications, and faster recovery times.

What is the recovery time after endovascular coiling?

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Recovery times vary per patient, location of the aneurysm, and whether the aneurysm ruptured. For patients with unruptured aneurysms who undergo endovascular coiling, recovery times may be as short as a month; other individuals find that they're back to baseline after about 3 to 6 months. If an aneurysm ruptures, recovery can take weeks to months; depending on the area of the brain where the aneurysm was located, permanent damage to the brain may occur.

What are the potential risks and complications of endovascular coiling?

There are some possible risks associated with endovascular coiling. These can include injury or damage to the artery or aneurysm being treated; in rare cases, the aneurysm can rupture. Vasospasm, or a sudden narrowing of the artery, can occur and lead to decreased blood flow to the brain which is fed by that artery. A blood clot can form on the catheter, the coils as they are injected, or in the artery where the catheter is fed. If this occurs, the clot can cause blockage of blood flow or a stroke. The coils may not stay in place or may not completely occlude the aneurysm; if this occurs, the aneurysm might regrow or get larger. Patients may have an allergic reaction to the dye used during the procedure. With any procedure, there is a risk of infection.

Medically Reviewed by a Doctor on 3/9/2016

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