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What if the surgeon is unable to reach the aneurysm with coiling?

Dr. Geoffrey P. Colby, MD
Neurosurgery

Coiling is a technique by which a catheter is introduced into the femoral artery in the leg, passed up through the arteries of the body, inside the head, and into the aneurysm. The aneurysm is then packed off from the inside with wire coils. These are typically very pliable, soft platinum coils.

In some cases the carotid artery is tortuous, curving, and loops back on itself. It's very difficult to pass a catheter through that and get to the aneurysm. If the carotid artery does not allow the passage of a microcatheter for coiling into the aneurysm, then one has to consider alternative treatments, and the primary one is surgery: craniotomy and clipping of the aneurysm in which it is sealed off with a clip.

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