I am 12 years out from my coiling, i have followed every recommended follow up, cerebral angiograms, MRA’s etc. This year the doctor want me to have another
cerebral angiogram. I am worried because its such an invasive procedure and if i am not having any problems why should i go through that procedure. The stress it is causing me is overwhelming. Has anyone had any similar experience? I hate to say this but is this just a way for the doctor to make money? Is it really necessary? With the advances in medicine why wouldnt another MRA be sufficent to see if anything has changed. Sorry for the long post but i think this group is the only folks who might understand my worries.
It’s definitely not a long post, no apologies needed! Please remember that angiograms are considered minimally invasive, craniotomies are invasive. I learned here about the radial entry instead of the femoral entry site and then had a radial with the last angiogram I had. It was a walk in the park comparatively speaking, Have you asked your surgeon why he wants an angiogram? Usually it’s so they can better see what’s going on than an MRA can provide.
Remember to breathe. There are many videos on YouTube to teach you mindfulness or relaxation breathing. I’ve found acknowledge my stressors for x amount of time and then focusing on other things helps tremendously.
Best of luck!
I did a bit of internet checking and some articles do have angiograms listed as invasive now. I’m unsure why the change. I generally stick with known sites such as NIH or WebMD. If anyone knows why articles are changing, I’d love to learn.
I am sorry to hear about your worries. If you are unsure, ask the Dr, neurosurgeon why he thinks you need a cerebral angiogram, that could be invasive? Also ask him the advantages, risks and disadvantages of this procedure. Unless you know all the whole facts, you cannot make up a logical, correct decision. Don’t let him force you into anything you are unsure or worried about. It has to be your decision, and it is your body. You should be able to talk to him. Thankfully I had an understanding neurologist and was in the room with another expert when ever receiving my MRI results as a follow up, so I found that I could talk to them.
Could you see another qualified person, or someone else that could help, including another neurosurgeon, if you cannot talk to him, or get an answer?
Have you had any recent MIR’s? If you have, this will show if your aneurysm is stable or not.
If it is stable, I personally cannot understand why he suggests another procedure. This should be queried. He may have a reason that we don’t understand, so it is best to ask. If he cannot give a reason?
If it helps, I have learned to calm myself down via breathing exercises simple Tai chi and in other ways.
There are many available on the internet, especially Youtube that could help.
I have a platinum coil from an operation nearly 6 years ago after a brain bleed, and live with another aneurysm on the opposite side of my brain, for which the neurosurgeon wanted to operate about 6 months after my original op. I shared my worries about the op, especially after still getting over my existing operation, and the neurosurgeon said that if I wasn’t completely sure about getting this operation he would postpone it, and just check the size of the aneurysm via MRIs, and see how it goes.
This was a good 5 years ago, and my aneurysm has been stable, so I haven’t had the other operation.
I also saw a qualified nutritionist who put me on natural vitamin C (anti-inflammatory, helps immunity and helps to repair). (Look up natural vitamins after a brain bleed, I just take these via my diet: Mediterranean Diet).
There are two sides to a coin (There may be another way without invasive procedures, surgery, especially if your existing aneurysm is not harming you in any way, and if it stable). Personally you shouldn’t need anything, if you are doing everything that has been asked of you, if the aneurysm is stable, and if you are feeling alright in yourself without the anxiety caused through this worry, why should you have to take an invasive procedure?.
Surgeons and Drs are trained in their fields, and a proper qualified alternative is trained in their fields.
You should be able to ask and get answers. I have done this, and keep on doing this.
Whether money comes into it is another issue. Whoever treats their patient should put their patients health and wellbeing first, not an unrequired action that may or may not cause harm.
I have never had an cerebral angiogram before, so I don’t know how invasive this is or isn’t.
Take care.
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Hi, I also am a little confused as to why its now considered invasive, but will ask my nurse…which brings me to my second thought - I find that Neuro Surgeons are so extremely smart and good at what they do, talking to them can be difficult because what makes sense to them dont always make sense to us - which is why and how I became very close to his nurse. Whenever I am stuck and not understanding his reasonings/explanations, I turn to her and she basically dummies it down for me - so is there a nurse you can talk to? My burst was in 2017 and I had a stent placed in 6 months after to block 2 other unruptured annies. I too had follow up angios, and only last summer did we replace the procedure with an MRI. It is my understanding that though MRIs are accurate - its always a better picture to see things through an angio…beside growth, they also look at coils, stents, whatever they used prior - as sometimes coils can get packed and need to be replaced, stents can move, so once they are in with an angio - these things can be taken care of/replaced right there…vs finding it through an MRI then scheduling an angio anyway. Maybe try looking at it as once it is done, it may bring you some peace of mind that all is good, all was thoroughly checked - and it may bring some relief ( this was how I got through all mine ) I have one coming up this July, not sure yet if its mri or angio but either way I keep thinking I will have comfort in the end knowing all is good and clear. We are here if you wanna talk, good luck & God bless
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My guess is that catheter angiograms are called invasive because they are! Since it requires the insertion of the catheter into the femoral or radial artery it is (by definition) invasive but also, it is not risk-free: it is possible for the guide wire used to navigate the catheter to tear the artery, creating a bleed; it is also possible to obstruct a small artery and create an ischaemic stroke; and there can be complications with the insertion site, so it is definitely not a procedure to undertake without due cause.
However, my understanding is that the placement of the contrast material in specific arteries means that the layout of the vessels and flow of blood (more important I’d think for my condition rather than that of an aneurysm) makes it very clear what’s flowing where. My assumption with a MRA is that it is always slices of a view through the body, whereas a catheter angiogram in the x-ray suite flattens all the layers into a single image and the contrast material injection at a specific location means only the arteries of interest show up. Much easier I imagine to see the full picture than flicking through lots of parallel slice images.
I think it is good to ask why it is important, especially if you’re concerned about the risks of the angiogram.
Hope something here helps,
Richard
When I first started with just the angiograms and no repairs, they were considered non invasive. The craniotomy was invasive because they crack your skull open to do the repairs. My neurosurgeon or someone on her team said angiograms were non invasive because it’s just the catheter going up the artery, back then it was always the femoral artery but they’ve moved to the radial. There’s a whole list of things that can go awry during an angiogram and you’re absolutely correct on not taking it lightly. Just the anesthesia has its list of negative possibilities, one being an ischemic stroke. I never trust an anesthesiologist who makes light of what can happen, each specialty is supposed to go over all the risks as they note in our record we understand the risks and have agreed to them, we also have to sign the consent form that says we understand the risks and that things not listed could happen. I used to be able to quote them both.
With aneurysms, just like AVMs, it’s really imperative for the Neurosurgeon to see the blood flow. I don’t think one is more important than the other as the surgeon really needs to see where the blood is going. Compacting coils can allow the blood to put more pressure on the aneurysm which can cause another rupture. They can also see if the walls of the aneurysm are weaker. Stents can move…The neurosurgeon goes to both sides to see if any more have developed as it’s a possibility and the MRA may not catch everything due in part to the Time of Flight and artifacts, something the Radiologist always notes.
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(Oh, a craniotomy is surely the most invasive thing you can do. I take my hat off to everyone who has gone through a craniotomy.)
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@DickD - My understanding is that the angiogram is still considered to be the “gold standard” for diagnosing aneurysms. My understanding of the risk of having one is similar to yours. It was my neurosurgeon who recommended that we discontinue doing them frequently because of the risk.
@Betty_S - as many others have written please ask your doctor to explain why he/she wants you to have another angiogram before agreeing to have one. I also invite you to read my response to MaryZPA re: “Watching and Waiting”.
I hope this is helpful.
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