Brain aneurysm coiling

A brain aneurysm is a small pouch that forms on the wall of an artery in the brain. If it ruptures, it causes serious bleeding (subarachnoid haemorrhage). Embolisation fills the pouch from the inside with very fine platinum spirals, called coils, so that blood can no longer enter and the aneurysm is excluded from the circulation. The procedure is performed under general anaesthesia in the catheterisation laboratory. A catheter is introduced through the groin or wrist and advanced to the brain arteries, then a microcatheter is placed inside the aneurysm. Depending on its shape, the doctor may use a balloon or a stent to hold the coils in place, or other suitable devices. This technique is used as an emergency after a rupture, and as a planned procedure for some aneurysms found by chance whose risk of rupture justifies treatment. The choice between embolisation and surgery (clipping) depends on the shape and position of the aneurysm; it is discussed between interventional neuroradiologists and neurosurgeons. At Clinique Pasteur Tunis, the procedure is performed in a latest-generation catheterisation laboratory, with neurosurgery and intensive care on site.