Incomplete coiling of an unruptured internal carotid artery

I have two coils in my internal carotid artery aneurysm near my cavernous sinus. Unfortunately, it did not completely close off the aneurysm. I have a small "tail' at the end of the coiled aneurysm. Right now I am be followed by periodic MRAs. Anyone else have an experience with this ?

i have a coiling in the basilar tip artery…on my follow up 6 mo exam n mra that there was a itty bitty pooch at the bottom of the coiling…this was back in oct 09 and have been doing excellent…have had 2 other mras since then and have recvd nuthing but great feedback,everything staying in place and anny rupture area has actually got smaller 2-3mm now…brain is doing fantabulous…your gonna be fine…God bless n wishing you a long…wonderful life!

Thanks so much for your reply. Most of the time I don’t really worry about it. But my last check up they mentioned possibly doing radiation to that area. I have not been able to find any research on this. I feel great and prefer to leave well enough alone. I continue with my regular check ups. Glad to hear you are doing so well! Thanks again.

If I understand your post they left a “tail” of a coil hanging out of annierism and in the vessel. This in fact did happen during a procedure with mine. They monitored it and the vessel eventually “enveloped” or “grew” around it as they thought it would. It did not prevent more coiling procedures.

Having reread your post maybe I misunderstood it and in fact the tail you talk about is blood still entering aneurism. It's not uncommon to not fully occlude and monitor for changes.

The norm should they feel required after monitoring over a TBD frame of time is insert more coils or stent it if they feel it is warranted.

I don't think your situation is highly unusual but that sure dosnt make it comforting - sorry.

The anuerysm is not fully occluded, the “tail” as the doctors refer to it remains after the insertion of two coils. My doctor wanted to insert a third coil but felt it was too risky, so I have this small excess at the top of the aneurysm. I’m okay with all of this. It’s taken me along time to regain my confidence and not worry about every new sensation in my head. My question is, has anyone heard of using radiation to treat the excess tissue?
Inserting another coil or stent is out of the question due to it’s location and the possibility of bursting it. At my last check up they mentioned radiation. I wanted to educate myself about this type of treatment for this particular scenario. I have not been able to find anything in the literature. Thanks for your response. Hope you are well!

i myself have not heard of using radiation…i do wish you luck on finding the info you seek…glad to see your doing great…

What size was your aneurysm to begin with? And did it rupture? I've never heard of radiation, but I've only been on this journey for less than 5mos myself -

When was your initial procedure?

Hope you find answers!

I have never ever heard of radiation as treatment in the way you explain. I have 5 years of many ruptures, leaks, coils and recoils and not done yet so I would like to think I stay pretty informed. Very interesting but maybe highly unusual. If I hear of it I'll get back to you. Good Luck on your trip on recovery road.

When you say "top" of aneurism are you referring to neck of aneurism? - assuming is a typical sacular type aneurism.

According to the NINDS, a saccular aneurysm is a rounded or pouch-like sac of blood that is attached by a neck or stem to an artery or a branch of a blood vessel.

Good Morning Maureen. I also belong to the AVM community and radiation is discussed as treatment.

"Radiosurgery - Small AVMs inaccessible to surgery can be eradicated effectively and at low risk using radiation. Stereotactic techniques used in conjunction with angiography allow physicians to identify the exact location of the AVM. High energy focused radiation in the form of proton beam can be directed to the center of the AVM to minimize injury to surrounding brain tissue". This paragraph was quoted from Brain Aneurysm and Arteriovenous Malformation Center at Massachusetts General Hospital.


I will research this further and get back to you. Take care.

I had an ACOM (Anterior Communicating Artery) Aneurysm that was not completely closed. Unfortunately at my six month follow-up I was told that my aneurysm grew and it needed to be clipped. So my ACOM aneurysm was coiled and clipped. My PCOM (Posterior Communicating Arthery) Aneurysm was clipped. Take care.

When I say top I’m not referring to the neck. It actually is at the point farthest from the neck. When the coils were placed in the aneurysm, there was this small area that just collapsed, at the top and to the left. The coils successfully blocked off the majority of the area except for this section. I do trust my neurosurgeon, but at my last visit he just tossed out this idea without a full explanation. As I said I would rather leave well enough alone.
After reading your response, I am continually amazed by the resiliency of the human body and spirit. It’s really helpful to hear other peoples experiences. Thanks so much for taking the time to respond. I will let you know what I find out along the way.

My aneurysm was almost 8mm. It did not ruptured, they found it because I had a sudden onset of double vision in my left eye and some very minor dizziness. My vision has never improved. My initial and only procedure was an endovascular coiling going thru my right femoral artery. Initially, I was followed every three months both by the neurosurgeon and the neuro-opthamologist, now every six months. I wish you well on your journey.

Sorry Maureen. I should have written the name. I was responding to R. Craig's question "When you say "top" of aneurism are you referring to neck of aneurism? - assuming is a typical sacular type aneurism".

Thanks so much for letting me know what you find out along the way. I just love to learn. I can't get enough. Thanks.

Thanks, I know gamma knife surgery has been used for AVM formations, but an aneurysm is somewhat of a different animal. Brigham and Women’s Hospital, Boston, does a lot of gamma knife surgeries but for AVMs and brain tumors, still haven’t found anything on using it for aneurysm. If I find anything I will let you know. I am lucky to live in this city with two world class hospitals.
Thanks!

What types of follow up have you had - you mentioned f/u every 3mos initially. I'm curious as to what types of follow ups people have w/ unruptured, coiled aneurysms, as I've heard different variations, and the two major hospitals near me have 2 different follow-up protocols. Both start w/ a 6mos follow up angio-gram (through the femoral artery), but after that they differ.

Thanks,

Jennifer

I have had many MRA some with contrast dye. I had them every 3months for the first year then every six months, now I will go to once a year. I think it’s different for everyone. I like to educate myself as much as possible about my situation so I can have some reasonable dialogue with all my doctors. It makes me feel like I have some control.

I do agree everyone is a little different it seems. I had figured I was 'bout educated as I was going to get and then I heard about radiation! Interesting stuff.

Donna,

I still et so confused...was your ACom coiled...and, later surgery/clipping and your PComA done at a different time?

Pat