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Research published in the August edition of the Hong Kong Medical Journal has shown that a new technique for treating haemorrhages caused by burst brain blood vessel swellings (brain aneurysms), is safer than traditional open brain surgery.
The research, performed by a team led by Dr Simon CH Yu is presented in an article entitled Endovascular coiling versus neurosurgical clipping for ruptured intracranial aneurysms: significant benefits in clinical outcome and reduced consumption of hospital resources in Hong Kong Chinese patients.
They found that when they compared the results of the new technique, called endovascular coiling, with those of traditional brain surgery (neurosurgical clipping) for treating patients with ruptured intracranial aneurysms, endovascular coiling led to a reduced need for intensive care unit admissions and better general clinical outcomes in Hong Kong Chinese patients.
Aneurysms are formed when part of a blood vessel wall weakens and expands to form a pocket in which blood flows into. A certain number of people have these in the brain but are usually unaware of this until it bursts, causing a brain haemorrhage.
Endovascular coiling is performed by interventional neuroradiologists, sometimes together with neurosurgeons. The procedure is to insert a plastic tube (catheter) into a blood vessel in the groin and then, using real time fluoroscopic x-ray images, up into the affected blood vessel in the brain. Once the catheter has reached the brain aneurysm, tiny platinum coils are threaded through the catheter until they coil up into the pocket or ‘sac’ of the aneurysm, blocking it up so no blood can enter.
The traditional method of repairing a brain aneurysm is surgical clipping, in which a neurosurgeon surgically open the skull, cut through brain tissue until the bleeding vessel is exposed, then put a tiny clip across the neck of the aneurysm to stop the bleeding. While neurosurgeons will try to avoid damaging vital parts of the brain when performing surgical clipping, some brain damage may occur from both the surgery and brain swelling that develops after surgery. If the bleeding blood vessel is in a place that is too difficult or dangerous to try to reach, surgeons may decide that the condition is inoperable.
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