Why aren’t all aneurysms treated with aneurysm coiling?

Dr. Geoffrey P. Colby, MD
The shape of the aneurysm, its location, and the age and medical history of the patient are all factors that determine whether we select endovascular techniques (coiling or flow diversion) or aneurysm clipping for treatment.

In terms of shape, aneurysms most successfully treated with coiling have a narrow neck that will hold the coils in place. Coils are packed into the aneurysm and essentially seal off the opening, or what we call the neck of the aneurysm. If the aneurysm has a wide neck or is large in size, the packing of the coils may not be optimal. In this scenario, placement of a stent might be needed to hold the coils in the aneurysm. Other good options include microsurgical clipping and possibly flow diversion.

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