New platinum coil technology makes minimally invasive surgery for brain aneurysms safer and cheaper

Loyola University Hospital is the first center in the Midwest to use new technology that makes minimally invasive surgery for life-threatening brain aneurysms significantly safer and cheaper.

Dr. John Whapham used the technology to repair an unusually large aneurysm (bulging blood vessel) in patient Randy Riiff of New Lenox, Il. Riiff went home the morning after his surgery, feeling tired, but experiencing no pain or discomfort.
The surgery took just 1½ hours. By comparison, minimally invasive surgery using standard technology would have taken about seven hours. And the longer the surgery, the greater the risk of anesthesia side effects and other surgical complications, Whapham said.

"The faster we can get in and out, the better it is for our patients," Whapham said.
Whapham led an endovascular neurosurgical team that included radiographers Daniel Arnswald, BSRT(R) and Tomasz Szkliniarz, RT(R) and nurses Vanessa Brunson, RN and Niakisha Jackson, RN.

About six million Americans -- 1 in 50 people -- have brain aneurysms that could rupture. Each year, aneurysms burst in about 25,000 people, and most die or suffer permanent disabilities, according to the Brain Aneurysm Foundation.
Traditional open-brain surgery to repair aneurysms is highly invasive. The surgeon opens the skull, gently retracts the brain and places a clip across the base of the aneurysm. Recovery can take months. Open surgery also can affect thinking skills by, for example, making it difficult or impossible to do complex tasks.

Whapham uses a less-invasive technique that's becoming increasingly common in brain surgery. He inserts a catheter (thin tube) in an artery in the groin and guides it up through blood vessels into the brain. He passes tiny coils of platinum wire through the catheter and releases them into the bulging aneurysm. The bulge fills with coils, causing the blood to clot and effectively seal off the aneurysm. "It's like filling a bathtub with concrete," Whapham said. The procedure is called a coil embolization.

Riiff's aneurysm was unusually large. At its widest, the bulge was about 17 mm. (about .7 inch) across. Typical aneurysms are 3 to 5 mm. wide. Riiff's aneurysm was discovered after he underwent a CT scan to investigate what was causing his severe headaches.

With standard technology, filling such a large aneurysm would require 40 or 50 coils and take 7 or 8 hours. Whapham used a new type of platinum coil, called Penumbra Coil 400®, which is four times longer than standard coils.

Consequently, Whapham needed only 12 coils to fill the aneurysm.

Coils cost $1,000 to $2,000 apiece, so using fewer of them will sharply reduce the cost of the surgery, Whapham said.

Moreover, the new coils are four times softer than conventional coils. This will reduce the small risk that a surgeon could accidently puncture a blood vessel wall while deploying the coils, Whapham said.

"This new coil is a game changer," Whapham said. "It's the start of a revolution in the minimally invasive repair of aneurysms."

Whapham is an assistant professor in the departments of Neurological Surgery and Neurology at Loyola University Chicago Stritch School of Medicine.
"He did a wonderful job," Riiff said.