The conventional treatment for aneurysms is surgical clipping. In this procedure, a neurosurgeon performs a small craniotomy, placing a small clip across the neck (opening) of the aneurysm, preventing blood from going into and out of the aneurysm.
The newer endovascular therapy for aneurysms involves placement of small, soft, platinum coils of varying sizes into the aneurysm to prevent blood from flowing into the aneurysm. This treatment has been performed safely for more than 20 years and has become a viable alternative to surgery. Initially, coiling was reserved for patients who were poor medical candidates for surgery, but it is increasingly being offered as first-line therapy. Enhancements to endovascular technology have allowed us to treat wide-necked aneurysms that just a few years ago would have needed surgery.
The appropriate treatment for any aneurysm depends on many factors, including the size, shape and location of the aneurysm and the patient's age and medical status. Consultation with a neurointerventional radiologist helps determine whether or not a patient with an aneurysm is appropriate for endovascular treatment.