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Adding a stent during minimally invasive surgery to repair aneurysms prevents recurrence
Date:7/26/2011

The addition of a simple stent can help prevent potentially lethal blood vessel bulges in the brain from recurring after they are repaired in a minimally invasive "coiling" procedure, according to new research by Johns Hopkins physicians. A report on the research, published in the July Journal of Neurointerventional Surgery, could make coiling a more viable option for the 30,000 people diagnosed with brain aneurysms each year in the United States, the investigators say.

Cerebral aneurysms, abnormal outward pouching of blood vessels in the brain, are traditionally repaired by an "open" operation, in which surgeons remove part of the skull, cut into the brain to reach the affected blood vessel, and then place a metal clip on the vessel where it balloons outward to close it down. In the past several years, surgeons are increasingly repairing aneurysms through coiling, in which they thread a platinum wire into a small incision in the groin, push it through the body's network of blood vessels to the bulging one, then pack the wire into the bulge where a natural clotting reaction closes it off.

Though endovascular (through the vessel) coiling has significant benefits compared to clipping, such as a lower risk of infection and recovery times measured in weeks instead of months, it also comes with a significant drawbackrecurrence of the aneurysm about a third of the time, says study leader Alex Coon, M.D., assistant professor of neurosurgery, neurology and radiology and director of endovascular surgery at the Johns Hopkins University School of Medicine. Traditional aneurysm surgery has a low recurrence rate of about two percent.

To avoid recurrence and the need for further surgery, some surgeons have experimented with insertion of a stent, or small tube, in the blood vessel near the neck of the aneurysm. The goal is to prop open the affected vessel so that more wire can be packed into the bulge.

To learn whether stents actua
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Contact: Christen Brownlee
cbrownlee@jhmi.edu
410-955-7832
Johns Hopkins Medical Institutions
Source:Eurekalert

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