Hello, I’m new the site. I was recently diagnosed with a 3-4mm unruptured BA behind the left eye. I have a strong family history of BAs due to Polycystic Kidney disease. My Surgeon mentioned I could either have it clipped (one and done) but more invasive or have a stent put in which is lease invasive. I understand with the stent I would be on blood thinners/aspirin and it will require additional testing. Not sure which way to go. Any side effects with either? I do have little kids and do not live close to family that could help.
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Hi @KH00 -
Welcome to our BA family!
O.k., o.k., as we all agree, no one actually WANTS to be here, but I trust you will find us a close and supportive community. Please ask as many questions or voice your concerns as much as you wish - we are here for YOU!
One thing we all observe is that our journeys are all unique, so you may not find someone whose journey is exactly the same - but, of course - we do have a whole lot in common regardless. 
As such, I will share my story in case that helps with your decision-making. I am part of the ruptured club. I was in a medically induced coma the first few days, I didn’t get a lot of choices, I just woke up to learn what had happened to me. 
My medical team went with endovascular procedures for me (i.e., I would be part of the Ruptured/Stent club to further refine), but I was still left with a small aneurysm, about 1.3 x 2.1 mm. I also developed hydrocephalus which did not resolve on its own, so I subsequently had two VP shunts installed (my non-endovascular procedures).
This fall, my neuroradiologist decided to retreat my aneurysm as it was growing, so I had a stent placed in October. Early results suggest that my aneurysm is no longer (official decision soon), so I am a very big fan of stents!!
Regarding side effects, for me, the recovery time is pretty quick (~2-3 days if they go in through the wrist (radial) or ~7 days if they go in through the groin). Even that recovery is pretty “easy,” in that you can get up, move around, just be ridiculously gentle with yourself, although I appreciate that will be even more challenging for you with little kids!
I should also disclose that I am one of those that has NOT had any of the potential side effects from endovascular (e.g., headaches). My recoveries (excluding the rupture and second VP shunt) are just to take it easy, and slowly build up to my usual routines. I just did my 3 mile walk this morning, and as I recall, I was doing that about 3 weeks post-stent last fall.
I do have to take baby aspirin for life, but since I take a number of other medications already, to me, what’s another pill or two when I am already taking 4 others? I am also on Plavix until the aneurysm is gone, so I hope to be off that sometime soon!
If it helps, I found this Medline Plus patient instruction article on Brain aneurysm repair - discharge which compares the two, if you haven’t had something similar from your doctors already. (I tried to look at it through your eyes, and I tried to not find a resource that was either too technical or too alarming, hopefully it is neither for you!)
I know others will soon chime to speak about their experiences and what side effects they may have faced. Please ask away or discuss your concerns as you wish.
Just know that we are ALL pulling for you! I am confident you will make the right decision for you and your family!!
I will keep you in my thoughts and prayers!
Fin Whale Fan 
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Wow, thank you so much for sharing your story! It is so helpful to hear what others have gone through. So happy to read that your early testing shows that the stent is working and that you had no major side effects. Also, thank you for the patient instructions. That’s the first time I’ve seen that. Thank you again!
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Hi and welcome 
. I’ve had a clipping and it was a hard recovery for over a year but my first one ruptured… I have another and they are going to use a clinical trial stent at the end of this month… my recovery should be much easier…
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Morning Ms.Kelly! Big welcome! I’m with the rupture group and have an oddly shaped multi-lobed aneurysm that’s been a bit of a headache (pun intended). The type of stent my Neurosurgeon installed was on my fourth attempt to make it go away. So far so good. In fact the procedure with the stent was my easiest so far! It’s also helped me improve a lot. It was my 3rd attempt that she thought she might need to do a craniotomy so we had our wills updated and other important things that needed addressed. I was on Plavix for shorter time than expected because I didn’t tolerate it well. Bruising went to bleeding that was difficult to stop so I bough a case of Vet Wrap from our Vet🤣. Cheaper on Amazon btw. I am on the 81 mg of aspirin for the rest of my life and like @FinWhaleFan, what’s one more?
I highly recommend you do a pro/con list of each type. Be frank (brutally honest) about everything, including the anesthesia which we seem to forget. What would you tell your best friend if they were in your shoes? It’s can be a bit scary to make this list, it may help to have someone with you while you do it. Just make sure whoever you choose is the upfront honest type and not the placating type of individual. You’ll have to have someone stay with you for at least 24 hours after an endovascular procedure. If you’ve already had an angiogram, it’s the same routine. I’m not sure how long with a craniotomy, hopefully someone who’s had one will let you know. There are different weight limits given to us, depending on the procedure. I recall my weight limit was different for the radial entry vs femoral (wrist and groin). I recall one member couldn’t pick up their little four legged friend for awhile with a craniotomy. I suggest asking your team about what’s recommended since you have little ones. Just use your patient portal, I learned it’s easier that way for everyone. Hang in there, we’re definitely here for you!
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Excellent points! You made me want to pull up my discharge notes, as you made me think that some details might help.
@KH00, this is what my medical team advised after my stent surgery, so, of course, yours may be very different, but my restrictions were:
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If the doctor has gone through the groin, please limit the use of stairs for approximately 24 hours if possible.
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Avoid heavy lifting (greater than 5 lbs) or strenuous activities (running, climbing, squatting, yardwork) for seven (7) days to prevent bleeding from your groin or wrist.
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If the wrist was used, protect it from bending for 24 hours after the angiogram
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You may take leisurely walks and slowly increase your activity as tolerated.
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No driving or operating heavy machinery for 24 hours.
Note, my stent procedure was an out-patient but overnight - essentially I was (supposed to be) there for less than 24 hours; therefore, the don’t do this for 24 hours were easy to follow as I was in a hospital bed for most of that time! Whenever they do a radial procedure for me, I ask for the nurse to wrap it up well (as if it was broken), as by nature I am a klutzy person, so I would rather be a little more restricted than take a chance.
For me, endovascular means no picking up my fur baby either! 
The bad part is that now he is trained on the “alternate method,” so that is the only way he eats anymore (dinner on the footstool instead of the floor). No, he is NOT spoiled or anything…
You’ve got this @KH00!
Fin Whale Fan 
P.S. This is STRICTLY anecdotal, but one thing (I think??) to consider is that by a doctor saying craniotomy is “one and done” implies that endovascular is not necessarily that way. Again, just my observation from within my own little world, but would definitely like something with more knowledge than I to give input on that.
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Thank you for sharing. I’m so sorry you had a hard recovery but hoping the stent will be much easier for you.
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Thank you! So happy to hear that the stent is working for you. How often do you get screened to make sure it is working? Great suggestion to make a pro/con list. Also, you gave me a few more questions to ask my Dr. especially about the weight limits.
I also am very clumsy. What a great tip about the vet wrap. I would have never thought about that. That would be good to have handy just in case. Thank you.
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Thank you so much! You all are so very kind to take the time to respond and sharing your wealth of information. I’m so very grateful. Taking it all in.
As for the one in done I think he was saying no medications (blood thinners/asprin) and fewer scans. I believe that is what I wrote down.
Also, I hope you are now able to pick up your fur baby. 
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If you lived near me, I’d give you your choice of colors! I still have a good bit left.
For me I’m being followed every couple of years thanks to Sergey. It was supposed to be every 5 but I had a hiccup and he ordered the MRI/A last year. The neck doesn’t want to stay closed and my pituitary adenoma they found during my ICU stay has grown. I’m not to concerned about the adenoma because it’s size fluctuates. In fact not concerned about the aneurysm not being fully occluded because it’s just as stubborn as me, I get it. It’s in a difficult spot and it’s a difficult bugger.
@FinWhaleFan reminded me with her list, ask your surgeon if you’ll have a forever weight limit after either procedure. I have a 40 lb limit that I constantly forget because it doesn’t work for me and what I like to do. If something’s marked by weight and it’s say 50 lb then I find a way around it but if not labeled, I don’t even think about it. The neurosurgeon who did my lumbar repair gave me the same weight limit so maybe they just learn that in school.
Also ask about the amount of protein they recommend. I was told minimum 90 gms a day in ICU by a person getting their RDN. I wasn’t eating, don’t want to eat if I don’t feel good. I later found out it’s what the US recommends, the WHO recommends 120 gms. You will also need to stay hydrated all the time because our brain likes it and they’re protein hogs.
For me, the once and done means you don’t have to think about coils compacting because they use a clip.
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Hi KH,
I had a ruptured Annie that was coiled in Dec 2023. I had a residual annie they left to watch. Turns out it grew quite fast. My neuro IR want to put in a flow diverter in June but I was skeptical. I opted for a craniotomy and got it clipped. Recovery for me was pretty quick (~2 months) with no adverse side effects or deficits. I don’t have a visible scar either.
I’m told I should be good for 3 years. My neurosurgeon did say my coils from my ruptured Annie have migrated out. So I may ask them to do an MRA sooner just bc I’m not sure what complications (if any) can be caused by migrated coils.
I wish you all the best with your procedure. I think both procedures are quite common. For me, it came down to who/what I trusted most after doing my research.
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Hello and welcome to the group from my listening post in 
your neighbour to the north.
I got the “ full-meal deal” in July of 2022 — one ruptured annie put me in hospital , and while they were looking they found 2 more unruptured. (Actually the third was a second lobe on the ruptured one but I digress.) I’ve had coils, a clip, a stent and more coils so I can tell you my experience with them.
The endovascular method is of course much easier on your body. I didn’t have a choice when I ruptured, they went in through my groin and coiled the first one which was on the basilar tip. (Stuffed the annie with tiny wire coils! The blood clots around them and prevents further rupture)
I then had a craniotomy to treat the one located on my MCA. The reason it had to be a clip was its location, and they had to cut my jaw muscle and move my eyeball out of the way to reach it. Sorry to be graphic but that’s what happened. (My surgeon was a fellow that I went to elementary school with, a strange coincidence that somehow calmed me as I headed into the OR).
The third procedure to treat the second lobe of the basilar tip annie was my final procedure of 2022 and they added a stent because like Moltroub describes, it is irregular in shape.
I had to recover from the clipping pretty shortly (maybe 2 weeks) after my initial rupture so my experience may not reflect that of someone who didn’t rupture. But all told it was a better recovery than I would have thought. But no picnic. I had a black eye and couldnt chew for a few days.
The difference really is in the follow up.
A clip is more of a slam dunk because stents and coils can compact or shift within the artery, whereas the clip is placed on the outside of the artery and cuts off the annie completely.
One year after all this, my angiogram showed that the clip was fine but that the coils in one of the basilar lobe aneurysms were compacting into the annie, and so more blood was entering the annie at the neck. They don’t want to see that. Over time it could lead to another rupture.
I’m not sure what the equivalent risk would be for the stent. So far my stent is causing no problems for me. 
What this all meant for me was that in November 2023 I had to have a “recoiling” of the basilar aneurysm — they packed in some more wire coils. (I told the surgeon to please pack em in tight this time! He laughed and told me each tiny coil costs thousands of dollars. Thankful for universal health care here).
I’m happy to report my latest angiogram (January 2025) shows no more compacting of the coils. So I will follow up with my surgeon next month I’m and hoping I won’t need another angiogram (I hate them) for a couple of years.
What I would say that helps me a lot is that if you choose the stent, they will (or should) continue to monitor you very closely with imaging afterwards. If something isn’t looking right they will likely go back in and so another procedure. This was my experience.
One thing you might want to ask is whether, if you choose the stent, would that prevent you from getting clip in the future if the stent somehow doesn’t work?
I have to say, the craniotomy is tough. I had one because I absolutely had to but based on my experiences, endovascular is much easier on your body, your brain and your mind too!
Good luck and let us know what you decide.
Cheers from Ottawa 
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Hi Cdyvsc, thank you for sharing. Can you explain what you experienced in your first two months after the craniotomy? Any side effects? Could you have done it with two little kids running around? Many thanks, Kelly
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Oh my goodness… you’ve been through it all. I’m so sorry but so grateful you are here to tell your story. Thank you! I will definitly ask what will happen if the stent does not work and could they come back and do the clip. How long did it take you to heal from the craniotomy? What sypmtopms made it hard for you?
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