Endovascular treatment of aneurysms and AVMs

Aneurysms occur when there is a bulging area in an artery caused by a weakness in the artery’s wall. Brain aneurysms, also called cerebral aneurysms, affect the artery that supplies blood to the brain. Arteriovenous malformations (AVMs) are abnormal tangles of arteries and veins within the vascular system. Endovascular procedures involve the insertion of a catheter through the groin to treat these conditions. Your surgeon may use different techniques to treat your aneurysm or AVM depending on your unique situation.

Aneurysms and AVMs can both be successfully treated with endovascular procedures, a less invasive way to treat these conditions compared to a craniotomy (drilling into the skull). These endoscopic procedures may be done to prevent hemorrhage or rupture, or to help stop bleeding if a rupture has occurred.

At the Northwell Health Institute for Neurology and Neurosurgery, our experts specialize in the management of complex brain aneurysms and brain and spinal cord AVMs. We offer a full range of treatment options and will evaluate your condition to decide on a treatment plan that’s best for you. Our endovascular treatment options for aneurysms and AVMs include:

• Coiling—Endovascular coiling requires the insertion of a catheter into the femoral artery in the leg. Your doctor will use real-time X-ray guidance to navigate the catheter through your blood vessels and into the aneurysm. Soft platinum coils are then threaded through the catheter and inserted into the aneurysm. These coils conform to the shape of your aneurysm, fill the sac and block blood flow to prevent the aneurysm from rupturing.
• Stents—Stenting is a procedure in which a physician inserts a slender, metal mesh tube inside your artery to increase blood flow in blocked areas. We also use Pipeline Embolization Devices (PEDs), a special type of stent used to treat brain aneurysms.
• Woven EndoBridge (WEB)—WEB is a new device that can be used to treat complex aneurysms that cannot successfully be treated with coiling.
• Embolization of AVMs—Embolization involves the injection of liquid adhesives (glue and/or Onyx) through catheters that are navigated from a small incision in the groin region (femoral artery) to the area of the AVM in the brain.

Your treatment risks and potential complications will vary depending on your individual condition and the type of treatment you receive. Your physician will discuss any potential risks and side effects with you ahead of your treatment. Generally, endovascular procedures are safe, but any surgery carries risks. Potential complications for endovascular treatment of aneurysms and AVMs are low, but include:

• Complications of the insertion of the catheter in the groin
• Brain hemorrhage
• Stroke

Your results will vary depending on your condition and the type of procedure performed. Generally, patients undergoing endovascular treatment of aneurysms and AVMs typically stay in the hospital for two to four days to prepare and recover, and then it may take an additional week or so to recover at home. If your aneurysm is complicated, or if it has bled, your hospital stay and recovery period may be longer.