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Microvascular clipping-this involves cutting off the flow of blood to the aneurysm. Under anesthesia, a section of the skull is removed and the aneurysm is located. The neurosurgeon uses a microscope to isolate the blood vessel that feeds the aneurysm and places a small, metal, clothespin-like clip on the aneurysm's neck, halting its blood supply. The clip remains in the person and prevents the risk of future bleeding. The piece of the skull is then replaced and the scalp is closed. Clipping has been shown to be highly effective, depending on the location, shape, and size of the aneurysm.
Occlusion-this involves the surgeon clamping off (occluding) the entire artery that leads to the aneurysm. This procedure is often performed when the aneurysm has damaged the artery. It is also sometimes accompanied by a bypass, in which a small blood vessel is surgically grafted to the brain artery, rerouting the flow of blood away from the section of the damaged artery.
Endovascular embolization-is a minimally invasive procedure that accesses the treatment area from within the blood vessel. During the procedure the patient is under anesthesia. A hollow plastic tube (catheter) is inserted into an artery (usually in the groin) and threaded through the vascular system to the site of the aneurysm in the brain using angiography (a procedure performed to view blood vessels in real time, after injecting them with a radioopaque dye that outlines them on x-ray). Using a guide wire, detachable coils (spirals of platinum wire) or small latex balloons are passed through the catheter and released into the aneurysm. The coils or balloons fill the aneurysm, block it from circulation, and cause the blood to clot, which effectively destroys the aneurysm. The coils are made of platinum so they can be visible via x-ray and be flexible enough to conform to the aneurysm shape. The procedure may need to be performed more than once during the person's lifetime. |
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