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Endovascular coiling is an endovascular treatment for intracranial aneurysms and bleeding throughout the body. The procedure reduces blood circulation to the aneurysm through the use of microsurgical detachable platinum wires, with the clinician inserting one or more into the aneurysm until it is determined that blood flow is no longer occurring within the space.
Clipping is a surgical procedure performed to treat an aneurysm. If the aneurysm is intracranial, a craniotomy is performed, and afterwards an Elgiloy (Phynox) or titanium Sugita clip is affixed around the aneurysm's neck. Surgical clipping was introduced by Walter Dandy of the Johns Hopkins Hospital in 1937.
Endovascular aneurysm repair (EVAR) is a type of minimally-invasive endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm (AAA). When used to treat thoracic aortic disease, the procedure is then specifically termed TEVAR for "thoracic endovascular aortic/aneurysm repair."
Clipping requires a craniotomy (opening of the skull) to locate the aneurysm, followed by the placement of clips around the neck of the aneurysm. Coiling is performed through the large blood vessels (endovascularly): a catheter is inserted into the femoral artery in the groin and advanced through the aorta to the arteries (both carotid arteries ...
Flow diverters are treatment for intracranial aneurysms alternative to endosaccular coil embolization, although the techniques can be combined, especially in large/giant aneurysms. It is mainly effective in wide neck unerupted saccular aneurysms , that are difficult to coil because of the tendency of the coils to fill the parent artery ...
The International Subarachnoid Aneurysm Trial (ISAT) was a large multicenter, prospective, randomized clinical medical trial, comparing the safety and efficacy of endovascular coil treatment and surgical clipping for the treatment of brain aneurysms. The study began in 1994.
The smaller the aneurysm the better the prognosis. There is less risk for ischemic myocardial damage and mortality with smaller aneurysms. Aneurysms with an internal diameter > 8 mm have poorer outcomes, since these aneurysms can be occluded and be associated with complications such as arrhythmias, myocardial infarction, or sudden death. [2]
Aortic valve repair or aortic valve reconstruction is the reconstruction of both form and function of a dysfunctional aortic valve. Most frequently it is used for the treatment of aortic regurgitation. [1] It can also become necessary for the treatment of aortic aneurysm, less frequently for congenital aortic stenosis.