Anterior Communicating Artery Aneurysm at 38 and surgery (Scared!)

Just went to doctor for a consultation and he suggested with my age I needed to go ahead and get this fixed. He is going to put me on Plavix two weeks before surgery and then go in Endovascular and fix it. He isn’t doing an Angiogram until the day of surgery and doing it all the same day? Anyone ever had one of these coiled or stented. Mine is a 3mm but 4 years ago I had a scan for family history and it was clear then, so this has developed in 4 years.

@Prissy110483
Hello and welcome to our group that no one would like to be a member of.
You will find many members that have had this procedure done, I am one of those. My aneurysm was in a different location than yours and it ruptured one morning almost two years ago, I am lucky to be alive! I got emergency care and the aneurysm was coiled, you can read my story in my profile. After the first follow up appointment with my neurosurgeon, he told me that he recommended a new procedure with a stent and more coils as the aneurysm couldn’t be fully treated when it ruptured. I also had to be on Plavix and Aspirin before the next procedure. This is the standard procedure. I was terrified! I had the option to wait and watch but the recommendation was to take care of it before it would possibly rupture again. It took me a couple of weeks to digest the information and I decided that it was in my best interest to get it fixed. Once I made my decision, I felt less worried about it. It helped me a lot to read about this in this forum, I was not alone and you are not alone.
My neurosurgeon assured me that the procedure would be a mild breeze compared to my experience when it ruptured. He was right. I had the angiogram procedure with a stent and more coils in the morning, came to the ICU where I stayed overnight and went home after lunch the next day. Just a mild headache for a few days, and the puncture site in the groin takes a while before it heals properly so you will get information what to do and not to do.
Sometimes they use the artery in the wrist instead of the groin and the recovery will be faster if they do.
Here comes a post that can help you prepare for the surgery

I can understand that you are worried about this, but I think it would be the best thing to do. You will be checked with an angiogram or MRA/MRI after a while to see that everything looks fine. You will most likely be on a anti platelet medication for the rest of your life, but a lower dose after a while.

When I was waiting to get into the operating room, I overheard a phone call from my neurosurgeon and he said “xxxx is my first patient today “ when I heard those words I felt so calm, I remember that I was thinking this is what he does for a living ….day in and day out……he is the expert in fixing blood vessels in peoples brains.

When is your procedure scheduled? Or is this about your father? Think about what support system you have around you. The recovery time is usually not very long but depending on the type of work you have you may need some extra time at home. Be prepared to take it easy for at least two or three weeks. You will get discharge information from the hospital.
Get your home in order,wash clothes and tidy up, prepare food and put in the freezer so you don’t have to cook the first days. We cooked a large plate with meatballs the night before the surgery, we cooked them in the oven, and forgot about it :sweat_smile: I think my husband and I was a bit stressed after all, thankfully we turned off the oven before we got to bed.
This was a long story for you. I wish you all the best with your surgery. Get back to us and ask questions. I know that @Moltroub has a lot of experience in this. I hope that more members will join you.
Take care of yourself and relax.

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My last procedure was done without the initial angiogram as the MRA showed her all she needed to know. Because of it being a stent this time, I was on Plavix. I bruised a lot, so be careful with what you bang into and dogs too big to really be a lap dog. Due to the stent, I just have to take 81 mg of aspirin, get the enteric type as it has a coating for your stomach. Remember to be hydrated before you go in for your procedure as it makes the arteries and veins much easier for them, and for you. One of the RNs that prepped me says it makes them “nice and fluffy for me” :joy:. Stay hydrated afterwards as it make healing much easier and it helps to flush the dye out. Make sure if you have any allergies to meds, you let them know, don’t forget this…I’m sure you’ll do fine, just a bit of work for you to make sure you and your body are ready. I always get my house in order, always. Get all the heavy house and yard work done, you won’t want to be doing any for a week or so. Read the article that @BF_Writer posted on getting ready, it helps a lot! Good luck and keep us posted!

And @oct20 is correct, I’ve had a lot of angiograms for one little popped bugger that looks like a blackberry and not a blueberry :joy:. Please heed her advice, she’s pretty smart about these things herself!

@Prissy110483

I’m completely with @oct20. Everything they say is :heavy_check_mark:

I am a moderator for another community. I have/had an AVM rather than an aneurysm but a lot of the risks and approaches are similar. I’m pretty bad with fainting when having surgery or anything to do with blood, so my first procedure with my consultant interventional radiologist was a combined angiogram and glue embolization: he was happy with what he was going to be doing based on an MRI and that doing the angiogram immediately before the embolisation was unlikely to show him things that would take him in a different direction. Since the embolisation is done under general anaesthetic, both were undertaken under general and I simply woke up later to learn what they had found / done. Honestly, it was an ideal way to go!

I subsequently had an angiogram as normal under local anaesthetic but I’d say the prospect of brain surgery was setting me sufficiently on edge that doing the combined first session was a good plan for me.

Hope this helps,

Richard

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Thank you all so much for the feedback…my appointment is scheduled for August the 29th and I am supposed to start plavix and aspirin Monday the 15th. I am so relieved to finally have a date to get this fixed but at the same time I can’t help but be terrified. Do aneurysms usually show up in other arteries since I have this one? How often after surgery should I get scanned?

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@Prissy110483
It is totally normal and understandable to be scared. For me who survived a rupture I must say that you are lucky to be able to fix this before it creates a disaster. I know it’s not easy to think like this, but it may help you to hear this from someone like me. I was scared too during the months leading up to my second procedure with a stent and more coils. My husband told me afterwards that he was more worried that it would rupture again before the surgery date. The neurosurgeon told us that if it would happen again,I would not survive……
I have not heard that we will develop any new aneurysms. Perhaps some other members have a better knowledge about it.
When you are under anesthesia, they will check all the other arteries in your brain with contrast. I was told that I only had one and they are not worried that any new aneurysms will pop up.
You will be checked with MRA/MRI or possibly a new angiogram some time after the surgery . For me it was an MRA/MRI at 3 months, second angiogram with the stent placement surgery at 6 months, a new angiogram 6 months after the second surgery and I will have a new MRI/MRA this fall which is 12 months after the last checkup. If everything looks good I think the next one will be two years later.
Once you are waiting for the procedure, the RN’s will do their best to make you feel comfortable, if you feel anxious, tell them. I remember the RN said, before we take you to the operating room , I will give you something that “takes the edge off “ she gave me medication in my IV and the next thing I remember was that I woke up, the doctor and my husband was standing by my bedside and they told me it was already over.
The hardest part is to wait for the surgery, we all know this. Do what you can to prepare yourself, and your home. Go for walks, eat well, perhaps try some relaxing techniques, calming music etc. There are for example different apps you can download with soothing music and sounds. Do what you can to pamper yourself before the surgery !
Do you have a friend that you can walk and talk with? Try to be in as good shape as possible before the surgery without overdoing it.
Remember that it is normal to be anxious about what awaits you. Let it out, we are here for you.
Please let us know how everything goes.
All the best to you.

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Thank you so much for the encouragement…It makes me feel so much better hearing all the other success stories. I think what has made me really nervous is the fact that my dad had a giant fusiform aneurysm 4 years ago and went in for a stent and coils and he never got to leave the hospital after that…he passed away due to his rupturing! I know there is so many that has had successful outcomes, I guess that is just what sticks with me is knowing he went in for the same procedure and never got to come home. He was 66 when he died and he had a brother pass away with a rupture at the age of 33.

Wow! I think we all understand that with a family history like that, it is going to put you on edge. However, we are all unique. How your body formed in your mum’s womb versus your dad or your uncle will be different. Your risks won’t be exactly the same as those of your relatives.

However we can cheer you along, let us know!

Very best wishes,

Richard

@Prissy110483
I’m so sorry to hear about what your family has gone through. I can definitely understand why you are worried. Please try to have a family member or friend to support you, also if someone could stay with you for the first days after the surgery, that would be very helpful. You will need a driver the day when you get home from the hospital.
I was scared too, but what made me go for the second surgery was that I couldn’t live with the knowledge that the aneurysm could rupture again, at any time. That would have been a heavy burden on my shoulders and for my family members too. Always thinking for every new sensation in my body, “is this it”??
Please ask for help among your family members and friends.
Get back to us and let us know.

Remember medical technology and knowledge has grown leaps and bounds. Neurosurgeons and anyone else in the medical field takes Continuing Education Units every year to help them stay on top of what’s happening in their field. Many will read studies and papers besides their CEU’s.

I usually get a follow up MRI/A which are two different images but done right after the other so it feels like one and then the six month follow up angiogram. I will finally make it to the every two year mark this December! No more angiograms for me, just the MRI/As which I think will be April next year. Because I have a pituitary adenoma, my Neurosurgeon has a special image for that every five years to see what it’s doing. She started that when I lost no weight, not an ounce in NSICU, now we know why is what she told me. I’ve probably had 10-12 angiograms since I ruptured in 2013, I’ve lost count.

Aneurysms can occur anywhere in our bodies, but I’ve only read a few here who have developed multiple ones. When my neurosurgeon checks mine, she also checks the other side of my brain during an angiogram just to rule out. It’s a safety precaution she told us. I really don’t want to rupture again, so I don’t mind her checking. Odds are with me I believe. I once had an Urologist start explaining aneurysms to me, I told her I might know a thing or two about them, and then we both started laughing. The poor Resident didn’t know what was so funny. Doc had to explain that I had ruptured and gotten my accent from the second procedure. Everyone is curious to my foreign accent syndrome and where I’m from.

It is really important to acknowledge your aneurysm but not focus all your time on it. Live your life! Focus on things you love to do, keep a positive attitude even if you don’t feel like it. It’s what gets us through, really. I do get my house in order because when she was going through my groin, it took longer and longer for me to get over the dye and anesthesia. I didn’t want the back log of chores fretting me. I think it was the third procedure with the balloon assist that we had a meeting with our attorney prior to the big date and updated our will and created a trust. It gave me more peace of mind then I can say. I have a litany of sorts that I go over with Dr. Q-W before she starts - did you get a good nights rest, have you eaten, do you need to go potty (I’m really serious about that, don’t want her doing the potty dance whilst she has a tube in my artery🤪). I always check in with my Higher Power asking that Dr. Q-W has a steady hand and mind, that she and her team are well looked after and if anything should go awry, that BH feels the love. It’s how I keep my House in order. BH is always more scared than I am when I have a procedure, always. So I try to laugh and joke, we go to a nice dinner the night before. Sometimes a fancy place, sometimes just with really good food. We usually spend the night at a nice hotel because it’s a bit of a drive for us and I have to be up at odd hours to take my premeds (I’m allergic to the dye). When it’s all over the next day, I usually get to go to my favorite tea merchant! A reward for job well done😂. I say usually instead of always because wouldn’t you know it, the pandemic put a damper on our routine.

Since your date is right around the corner, enjoy some walks, enjoy the company of friends and family you love. Don’t spend time with someone’s drama and chaos, it’s too draining, unless you have to deal with it for work of course.

@oct20 is dead on for how well trained and nice the RNs are, I’ve had many a great one. Most of them know me by now unless they’re rotated out. But boy are they ever good about getting the IV started, helping us calm down and for me, we joke a lot. I think with all the procedures I have under my belt, my favorite Nurse Anesthetist was John. He didn’t lie when he said he was going to put me in my happy place and keep me there while Dr. Q-W put my stent in. He actually had read his part of my medical records and before I could tell him, he told me he’d give me enough to knock out an elephant. I didn’t need to be awake apparently. He also knew I talked in my sleep so he said he was going to get all my secrets. I told him it wasn’t my birthday, not Christmas nor Chanukah so I had no secrets🤣

I have a very strong feeling you will do remarkably well. Keep posting here and don’t forget to come back after your procedure to let us know how it went!

Yes. It was decided after the diagnostic angiogram to treat by clipping/craniotomy the next morning instead of clipping/stents, because of the size and location of my anterior communicating carotid artery aneurysm. I am 35 years older than you and was also scared out of my mine too. With the exception of a few expected post op bumps in the road, I am well. From what I understand, coiling and stenting has much less post op complications than a craniotomy. But regardless, of which surgery, it is still scary before hand.

Just the relief of not having to worry about a rupture for that artery and I am very fortunate to have very few recovery issues.

You were very wise to get an MRI/A because of your family history. Mine were found by “accident” from an MRI ordered by my audiologist for a potential acoustic neuroma for hearing loss. No neuroma but multiple aneurysms.
Both my grown kids and sister are having MRI/As at the request of my endoneurosurgeon.

I wish I had known about this very kind and informative gathering of support before and immediately after my surgery. I know now and look forward to hearing about your wonderful progress!

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I want to thank each and every one of you for your feedback and encouraging words, they truly have put me more at ease. My procedure is 3 days away now and I am just ready to have it over with. The Plavix has been the worst part for me so far, because I am hyperactive to it and they have now cut it back to half a pill every other day because my blood is too thin. It really has made me feel so sluggish and drained. I am still scared but this site and reading all the journeys has really helped put me at ease. I think my biggest fear is rupturing on the table while they are in my artery, but I definitely want the peace of mind afterwards to not have to worry about this bomb in my head any longer.

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We certainly can relate to the stress that occurs before a procedure! I won’t tell you not to worry about the uncommon possibilities, seems like we often do. I can tell you that for each procedure I’ve had, being of a positive mindset has really helped. That and being hydrated…best of luck to you and please let us know how it went if you don’t come back on before then…

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@Prissy110483
Only a few days and then this is behind you! It is normal to be worried, we all know that feeling. To worry about a rupture while they are inside the artery is understandable, try to think of it this way, if it happens, the neurosurgeon is already in the right place to fix the problem and they have a plan ready to do so.
I was also hyper responding to Plavix, I thank one third of a pill twice a week was enough for me. They also checked the blood levels the morning of the procedure.
When I was waiting for the procedure to be done, I told my family that I didn’t look forward to it, but I looked forward to have it behind me.
Please get back to us later and tell us how everything went.
I wish you all the best.

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Well update on me…I went in for angiogram and coiling or stenting if they needed to and doctor didn’t have to could or stent because he said that it was an infundibulum in my Anterior Communicating Artery and not an Aneurysm. He said it was very rare to have an infundibulum in this artery but he was almost positive this was the case. He is going to check it with a CTA in a year to make sure it doesn’t change. So relieved and confused at the same time. He didn’t seem 100% confident in that diagnosis. Anyone else ever had this? I also developed a hemotoma at groin site and it is now very black and painful. I didn’t have to stay since the didn’t coil or stent so I am at home resting!

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I’ve read so many stories about infundibula recently, I thought I should look it up. It seems quite common to not be able to distinguish infundibula from aneurysms with MRI or CT, as described in this article. Having looked at you via catheter angiogram, it should be more certain but it sounds like he’s having you in again in future to see if it is changing / your risk changes at all.

Thanks for the update! I once had a nasty hematoma at the femoral artery. It took a few months to heal. The weight limit they gave you on picking up things is really important so please follow it! I couldn’t even pick up a half gallon of milk. When my Neurosurgeon doesn’t come across as 100% positive, I ask her. Sometimes I’m mistaken. When I’m not, it’s usually because she doesn’t think she has had the aneurysm fixed. The last one did it’s job and I’ve never heard her pleased with herself until then. It may be because the anomaly in your artery isn’t quite formed well enough for him to tell, I’ve read here that has happened to others. But as my Neurosurgeon always tells me as does her NO, if I have any questions, just ask. They use the adage “There is no stupid question, except the one that wasn’t asked”. Please reach out in your patient portal or give his office a call to clarify.

@Prissy110483
Thank you for the update.
I can understand the mixed feelings you have about the result of the procedure. I would suggest that you reach out to the doctor in a few days and ask again. All health professionals knows that information needs time to sink in and to be processed and more questions may arise. Especially when you are under stress of having a procedure done. Don’t hesitate to ask again!
Just ask if you need to be worried about it. They will understand.
I have done it myself when I was unprepared for the information that I needed a second procedure to insert a stent and more coils. I simply said, could you please repeat this for me again? And in my case, I said that I needed time to process the information to decide what to do. We agreed that I would get a phone call back by a resident after two weeks and when I got the phone call, I said that I was ready to get it done. I’m also sure that your angiogram results will be discussed by other doctors if he is unsure.
Regarding the hematoma, rest and follow the instructions you were given.
Did you get off the Plavix now when the diagnosis is different?
Rest, rest, rest. Follow the instructions!

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