Got my angiogram results

Hey guys,

I promised I would keep everyone updated. I just met with my consultant who went through my angiogram. They originally thought it was 8mm but have now found it was 10mm. Has anyone heard of this? i.e. it changing size following an angiogram.

Is 10mm big? They want to do endiovascular coiling which I'm much happier with but I haven't got a hospital date which isn't great. I've waited around so much and have a holiday in 10th Dec. I'm not sure whether to go ahead or not.

Thanks,

Sarah

Hi
I am going to the surgeon this morning. I have another anuresym. It is only 2mm but I am going to ask that it be coiled. Holidays come and go. Take the time to get yourself well. I will pray for you.

Best
Marie

I think 10mm is fairly big. I would go ahead and travel and let them know you are not available that week. I waited a year for my coiling - it was stressful to wait all that time for sure; but we went to New Orleans and enjoyed ourselves - just in case I didn't get another chance. Procedure went well, but I have residual dizziness daily now. I am sure all will go well for you. I worried too much and in hindsight, I should have had more faith in my surgeon.

Hi Sarah,

definitely possible since the angiogram is a LOT more precise than whatever it is you did previously - MRI or CT.

In my case the size was right on CT but the angiogram revealed a second aneurysm, much smaller - 2mm, not visible on the CT. And that's even worse news to get than a bigger aneurysm :-)

And yes 10 mm is big, almost a giant aneurysm. If I were you, I would go ahead with it as soon as possible, you'll feel relieved and happy once it's done. The coiling is really no big deal, it's a 3-day stay at the hospital max and then you're back to your old self :-)

I wish you all the best and let us know what you decide to do!

At first look, mine was thought to be 4 mm. Following the angiogram, it measured 6.5 mm. I asked why there was such a change. I was told angiogram provides a better picture. I waited 6 weeks for my clipping. Those were the longest 6 weeks of my life. My clipping was in December 2010. Holidays were a blurr but i know i wouldn’t have enjoyed them waiting any longer.

I’d opt for clipping because I’ve heard coils can move…

Hi Sarah.

Thanks for letting us know how you are getting on.

See below some info on size and risk take from a study which puts things in perspective for you.

Results

In group 1, the cumulative rate of rupture of aneurysms that were less than 10 mm in diameter at diagnosis was less than 0.05 percent per year, and in group 2, the rate was approximately 11 times as high (0.5 percent per year). The rupture rate of aneurysms that were 10 mm or more in diameter was less than 1 percent per year in both groups, but in group 1, the rate was 6 percent the first year for giant aneurysms (≥25 mm in diameter). The size and location of the aneurysm were independent predictors of rupture. The overall rate of surgery-related morbidity and mortality was 17.5 percent in group 1 and 13.6 percent in group 2 at 30 days and was 15.7 percent and 13.1 percent, respectively, at 1 year. Age independently predicted surgical outcome.

You can get the full report at http://www.nejm.org/doi/full/10.1056/NEJM199812103392401

Some scans/angiograms are more precise than others, that is a possible explanation for the change is size, in the grand scale of things 10mm is not considered to be giant sized, but from my experience with my Endovascular specialist, he would coil and stent an aneurysm this size.

In fact this is what he did to 2 them last year, with one of a similar size and one smaller.

The procedure itself is painless and hassle free, 2 days in hospital, a great sleep and the job is done, so there is nothing for you fear.

If I was you I would find out when they want to do it, then I would go on holiday.

Best Wishes

Martin

Hi Sarah.......oh yeah, 10mm is big. I have two of them that size, one on the left and one on the right. Both close to my optic nerves. They were spotted on a cat scan. To know they are there before they burst is a good thing. BUT, when they were discovered they did not wait around, they went in and coiled the first one three days after discovery and the other one six days after that. It was a rough couple of weeks but everything went well and I was lucky that both had small enough necks to be coiled with no stints or major surgery to my head. I was in the hospital for four days the first coiling and three days the second coiling. I was a sick puppy but except for some minor issues, I seem to be pretty normal. I just had my first MRA (7 1/2 months) checkup last Thursday and all looked good. I had a marvelous surgeon obviously. It is a very frightening thing because they tell you all the terrible things that can happen, but I went into it with great faith in my surgeon and with my family all waiting for me to start ordering them around again. I don't know where you are but I would question their waiting around and not doing something immediately. Good luck and just try to keep your chin up. Keep us posted, we will all be thinking about you. Muriel

You should take the doctor’s advice. Clipping has a much higher risk of infection and a longer recovery time. If you have any doubts, get a second opinion.

Mine was a 10 and it ruptured last Dec 16th. There was a second annie that also ruptured near the first one. Spent two months in hospital & rehab. facility. I agree with Marie & Donna but especially with Tania. A three-day stay beats 2 months! Good luck.

I can only relate to my own experience. My aneurysm was discovered on an MRI. It was described as “giant” and measured approximately 5 cm in size. Perhaps whoever measured your aneurysm, originally made a mistake in the size. 2mm probably won’t make too much of a difference in treatment, though every mm is vast when it is in your brain. The best of luck in the treatment. Coiling seems to be the first treatment of choice these days. Clipping, which I had, requires a craniotomy, which you wouldn’t want to experience. God bless you.

David Andrus.

If you’re a good candidate for coiling, go for it. I wasn’t (mine had ruptured already and also had a wide neck) so I had to clip. Longer recovery for sure but I’m doing fine, raising kids with my husband and working almost full time

Get a second opinion and if that neuro agrees, then you can feel comfortable. See if they can expedite your surgery date - be persistent - so that you don’t rupture in the meantime. Also - this is just my opinion - I wouldn’t travel far from hospital til it’s done. You don’t want to be on some island with a ruptured aneurysm. Best luck and wishes!

I had a 12.5 mm SAH it was considered medium I think by my doctor. One nurse had told us it was 12.5 cm. Luckily, my partner is well versed in metric conversions, and sought out the beloved medical student who was always around. We knew nothing about aneurysms at that time.

So I went to stroke association.org. And found this: "Brain aneurysms are all different. They vary in size, shape and location.

Size

Small aneurysms are less than 5 mm (1/4 inch).
Medium aneurysms are 6–15 mm (1/4 to 3/4 inch).
Large aneurysms are 16–25 mm (3/4 to 1 1/4 inch).
Giant aneurysms are larger than 25 mm (1 1/4 inch).
Shape
Aneurysms can be:

Saccular (sac-like) with a well-defined neck
Saccular with a wide neck
Fusiform (spindle shaped) without a distinct neck

Here’s the link for the above http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/What-You-Should-Know-About-Cerebral-Aneurysms_UCM_310103_Article.jsp

And of course, our wonderful BAF has this on their website: http://www.bafound.org/sites/default/files/Introduction%20to%20Brain%20Aneurysms%20and%20Their%20Treatment.pdf

It explains aneurysms and both methods of treatment as well as why doctors choose the type of treatment. I liked it.

As for your holiday - talk to your doctor and family/friends. Your doctor may want to wait until after the holidays.

Cliff at the age of 67 had an aneurysm that was 10mm in size. He had it operated on in January 2011. They decided against using coils because it was so large. Instead they decided to use clips. But because it was so large, during the surgery they found that it was too large to completely contain with just clipping so they also wrapped it in muslin. He has done unbelievably well. Except for a short period of fatigue that was relieved by taking more iron, he now walks three of four miles each day, his cognitive skills are still intact, his sense of humor even sharper than ever. People are amazed that he has had this surgery. So do not be afraid just because your aneurysm is so large. There are many examples like Cliff's where people go on to lead very full and productive lives. We will keep you in our hearts and we wish you the best of luck. Stay positive!

Sometimes different equipment measure differently?
My aneurysm was 12mm!
The doctors were able to coil it with a stent to keep coils from falling in blood vessel afterwards… I did need a few revisions to add coils you may not have that problem…

Hi Sarah,
I know every case is different, but I have an 11mm aneurysm on my anterior communicating artery (AComm) which ruptured in feb of last year. While it is not considered “giant”, i consider it quite large considering that the artery from which it was formed is only about 1.5mm in diameter. I had it coiled at the Mayo and am doing pretty well., although still in recovery. I have another small one (1-2mm) that they are monitoring.
If I had a 10mm u ruptured annie, I would get it coiled immediately, as you can imagine that a 1-2 mm artery ballooning out to 10mm means that the aneurysm wall might be getting quite thin. I am very happy with my coiling. It is far less invasive than clipping and the recovery time is much shorter. In the meantime, be very careful not to increase the intracranial pressure in your head. They may have already told you, but do not exert yourself or put your head upside down or at a downward angle. My docs have also told me to stay away from gardening, as many have ruptured during gardening. Manage your stress and your blood pressure. I don’t mean to scare you, but a rupture can be devastating and you do not want it to rupture if you can prevent it. I had no idea I had an aneurysm before my rupture, but if I knew I had one that size I would have taken care of it immediately. Just make sure you have a doc who has done many of them with high success rate over a long time. Please take care, I’m adding you to my prayer list!

Mine was 6mm and describes as tri-lobed. Has anyone heard of that? It was coiled successfully after it ruptured.

Hi Sarah,

I have one at 10mm and another growing from that one at 8mm. Had both of them coiled in 2008 and never looked back. It is quite scary to see them on the scans, as they look enormous, but you will feel much better once they are dealt with. Good luck.

Sarah

Hi all
Just came back from surgeon. I have a 2mm anne which I will have an angiogram on December 10th. It will be monitored if it is too small to coil. After dealing with a ruptured anuresym 4.5mm, SAH and vasopasms and not being able to participate in decision making, now I am well informed and taking time to make smart choices.
Bottom line take care of that Anne. I too am afraid and scared everyday, but then I come here and talk to others.
All the best
Marie