Treatment for Brain Aneruysm

Surgical techniques and minimally invasive endovascular approaches to treating aneurysms have different strengths. UT Southwestern neurosurgeons offer expertise in both options.

As a result, we work with patients to determine which solution will achieve the most effective results. The technique we use depends on each patient’s unique situation – along with the size, shape, and location of the brain aneurysm.

Because UT Southwestern is a major referral center for brain aneurysms, we have access to the latest technologies and treatments before they become available at other places. That said, we don’t employ these options before they are ready. We study and test them and have them available when the right circumstances arise.

Highly Experienced in Treating Brain Aneurysms

Our strong culture of surgical treatment of aneurysms spans more than 30 years. For this reason, UT Southwestern is a major referral center for complex cases from Texas and many surrounding states.

Our approach now involves two neurosurgeons who are trained in surgical and endovascular techniques, along with radiologists and neurologists who provide endovascular expertise. Frequently, you have to see only one specialist for an opinion about all treatment options. Our goal is to offer a well-rounded approach and 24/7 availability. 

Minimally Invasive Endovascular Options

Coiling

Endovascular coiling is a minimally invasive technique, which means we do not need to make an incision in the skull. We use a catheter to reach the aneurysm by passing it through the groin up into the artery containing the aneurysm. We detach a coil (or coils) from the catheter and place it in the aneurysm.

These coils slow down blood flow and cause the blood to clot. Most of the time this will result in a scar forming across the aneurysm neck. This effectively heals the aneurysm and helps prevent future rupture. Coils are made of platinum, so they're visible on an X-ray and flexible to conform to the shape of the aneurysm. Also, an MRI can be performed when these coils are present.

When performing a coiling procedure, we may use additional devices, such as a stent to help keep the coils in place. Stent-assisted coiling involves placing a mesh stent in the blood vessel adjacent to the aneurysm to provide scaffolding to keep the coil within the aneurysm. Patients need to be able to be on blood-thinning medications if a stent is placed. 

Flow Diversion

UT Southwestern has long experience in the use of flow diversion for difficult aneurysms. These stents are similar to a traditional stent but are more tightly woven and placed in the parent blood vessel to divert blood flow away from the aneurysm – think of “chicken wire” versus a “stocking.” These stents have the potential to reconstruct the wall of the artery and restore natural blood circulation.

Flow diversion removes the need to enter the aneurysm during surgery but requires the use of blood-thinning medications for a longer period of time than traditional stent devices. We will discuss the risks and benefits of these procedures with you in detail. 

Surgical Treatments

Clipping

To clip an aneurysm, a neurosurgeon must open your skull and place a small metal clip at the base of the aneurysm to tie off the bulging section of the artery. This eliminates the danger of a rupture by taking the pressure off the weakened area of the blood vessel. 

Because of the large number of referrals we receive, UT Southwestern neurosurgeons maintain surgical expertise and continue to offer surgical treatments for patients who would benefit from surgery (e.g., for those whose aneurysms are more likely to recur with coiling or those who are not able to take blood thinners, etc.)

For an unruptured aneurysm, a patient typically spends three to five days in the hospital before being discharged. The stay is longer after surgery for a ruptured aneurysm.  

Bypass Surgery

Extracranial-to-intracranial bypass surgery to treat complex, unclippable brain aneurysms is performed at only a few major U.S. medical centers. As with surgical “clipping,” the volume of cases referred to UT Southwestern allows our neurosurgeons to maintain expertise in these delicate procedures that treat aneurysms and other diseases such as Moyamoya syndrome and tumors of the base of the skull.

Recovery and Rehabilitation

After treatment, patients recover in our dedicated neurointensive care unit. The length of the stay depends in part on the treatment received.

We also offer neurorehabilitation for those who need physical, occupational, or speech therapy.

Request an Appointment

To schedule an appointment with a brain aneurysm specialist at UT Southwestern’s facilities in Dallas or to learn more about our services, request an appointment or call 214-645-8300.