A fender-bender may have saved Douglas Collins' life. A CT scan following the accident discovered Collins, 64, had a brain aneurysm, a weakness in the arterial wall that if ruptured could cause a stroke or death. It was not caused by the accident, but likely could have been a ticking time bomb present for years. The aneurysm was large and previously thought to require open surgery and a lengthy recovery.
A second opinion brought Collins to Rush University Medical Center and Chicago Institute of Neurosurgery and Neuroresearch (CINN) neuroendovascular specialist Dr. Demetrius Lopes. Lopes recommended a new approach combining the use of intracranial stents and coil embolization to strengthen the artery with no need to open the skull. Dr. Lopes is one of the most experienced physicians in the world with this new technique.
"Obviously, why would I want to undergo a long recovery period if I don't have to," said Collins. "I chose to have Dr. Lopes perform the procedure and it was a complete success. I was back on the golf course within days."
Until recently, people like Collins with wide-necked aneurysms in the brain would not have been candidates for coil embolization, a procedure in which tiny coils are used to close off the aneurysm. To deliver the coils to the aneurysm, a catheter is inserted into the femoral artery, located in the upper leg, and threaded through the artery and into the blood vessels of the brain.
Historically, if the aneurysm was more than 4mm, the "wide neck" of the aneurysm prevented the coil from staying in place on its own and the aneurysm was very likely to return. The recent introduction of flexible intracranial stents has provided a method of preventing the coil from migrating out of wide-necked aneurysms. Therefore, more patients can undergo minimally invasive interventions to repair their cerebral aneurysms.
The initial treatment stage involves placement of the stent in the artery across the aneurysm neck. A microcathether is navigated through the stent struts into the aneurysm sac. The second stage consists of filling the aneurysm with coils. The stent works as a scaffold preventing the coils from migrating out of the wide neck aneurysm. The body responds by forming a blood clot around the coils and new tissue growth around the stent strengthening the weak spot in the artery.