Stanford Hospital & Clinics offers all of the latest treatment options for brain aneurysm care, including microsurgical surgery techniques and minimally invasive endovascular techniques, which treat the aneurysm from inside the blood vessel using minimally invasive techniques. Our highly experienced neurosurgeons, neuroradiologists, neurologists and nurses work together to develop the right customized treatment plan for each patient's unique needs in partnership with the patient and family.
Each brain aneurysm is different and treatment is determined through careful consideration by your care team. The goal of treatment is to close off blood flow to the aneurysm to prevent the risk of hemorrhage in the safest way possible.
Specific treatment for a brain aneurysm will be determined by your care team based on:
Your age, overall health and medical history
Extent of the condition
Your signs and symptoms
Your tolerance for specific medications, procedures or therapies
Expectations for the course of the condition
Your opinion or preference
Depending on your situation, the physician will make recommendations for the intervention that is appropriate. Whichever intervention is chosen, the main concern is to decrease the risk of a subarachnoid hemorrhage, either initially or from a repeated episode of bleeding.
Many factors are considered when making treatment decisions for a cerebral aneurysm. The size and location of the aneurysm, the presence or absence of symptoms, the patient's age and medical condition, and the presence or absence of other risk factors for aneurysm rupture are considered. In some cases, the aneurysm may not be treated but the patient will be closely followed by a physician. In other cases, surgical treatment may be indicated.
Primary surgical and endovascular treatments for a brain aneurysm
The brain aneurysm team performs hundreds of surgeries each year, using the most advanced equipment and technologies available to achieve excellent outcomes. Stanford Hospital & Clinics neuroradiologists have been pioneers in developing safer, more effective endovascular therapies for more than 25 years.
Open craniotomy (surgical clipping)
This procedure involves the surgical removal of part of the skull. The physician exposes the aneurysm and places a metal clip across the neck of the aneurysm to prevent blood flow into the aneurysm sac. Once the clipping is completed, the skull is sutured back together.
The brain aneurysm team performs hundreds of surgeries each year, using the most advanced equipment and technologies available to achieve excellent outcomes.
Endovascular coiling or coil embolization
Endovascular coiling is a minimally invasive technique, which means an incision in the skull is not required to treat the cerebral aneurysm. Rather, a catheter is advanced from a blood vessel in the groin up into the blood vessels in the brain. Fluoroscopy (a special type of X-ray, similar to an X-ray "movie") will be used to assist in advancing the catheter to the head and into the aneurysm.
Once the catheter is in place, very tiny platinum coils are advanced through the catheter into the aneurysm. These tiny, soft, platinum coils, which are visible on X-ray, conform to the shape of the aneurysm. The coiled aneurysm becomes clotted off (embolization), preventing rupture. This procedure is performed either under general or local anesthesia.
Pipeline flow diversion
This minimally invasive approach is performed by threading a catheter through the groin into an artery and placing coils into the dome of the brain aneurysm to fill it and close off blood flow, preventing future bleeding.
In some cases, the placement of a tiny tube, called a stent, or a balloon is needed to ensure safe coil placement.
Pipeline flow diverter surgery
If the structure of the brain aneurysm is wider, then a pipeline stent will be inserted inside to reconstruct a new wall for the artery so blood cannot fill it.