Mixed Signals After Recent Angiogram - Choices To Be Made

Last Friday 10/5/2012, I went for my 3rd followup angiogram after a 2010 Coiling of a ruptured aneurysm. The original aneurysm measured about 5x6mm with a neck almost as wide as the width. However since it was dual lobbed they were able to place enough coils to seal the entire thing without using a stent.

Here is the time line:

An 8 month followup angio folowing the original coiling showed slight coil compaction, where the doctor describes it as "a fraction of a millimeter" and suggests another angio in one year.

12 months after that a second angio shows a little change from the previous one and they say, we will see you in a year.

12 months later, Friday 10/5/12 a third angio shows little change from the last one, but now is showing a distinctive change from the time of the coiling. Still in fractions of a millimeter. In other words, from test to test there is little change, but now with 4 studies there is an disctinctive change from the first to the 4th.

So since last Friday two doctors (partners in the same hospital) have conferred and have slightly different opinions. The doctor who did my coiling says to wait another 6 months to a year, the other feels I can move forward with a stent and coil “If I choose”. Other choices of clipping and pipeline are not options due to anatomical considerations. They explained the risk of the procedure may make things worse, but the wait and see approach has its own risks They came to a consensus of doing an MRA in 3 months to verify that they are just dealing with compaction and not a growing aneurysm. They say the dome is still covered but the neck is starting to be exposed. They ended the conversation staying, “we know this is a very difficult choice, call us at any time with any questions you have. If at any time you make or change your mind, we will handle it the way you want”.

I am actually in a worse predicament that before the angio last week and and completely torn on what the next move is. Sleep has been very difficult. So I here I sit already having 2 opinions of very skilled doctors and I have no idea what I am going to do. Very frustrating . . .

If who has had a similar experience please let me know. Thank you!

Hi Tony

I haven't had the same experience, but I do know something about deciding the best treatment as my aneurysm was found before it ruptured and there was discussion about whether and how to treat. I have a medical background so looked up all the published literature relevant to my situation, but the decision wasn't easy.

Perhaps asking about the risk of rebleed if treatment is delayed would be useful info, and also the risk of complications with any procedure. It may be that delaying by 6-12 months may not really be risky, but any further change seen at that point would bring them into agreement. I'll pray you have peace of mind and ability to sleep!


If it were me, I think I'd wait out the three months and see what happens but take it very easy during those 3 months, before I made a decision. Waiting is the most difficult because as human beings we want action. And I know it's scary too. Sending you lotsa hugz and prayers.

i agree with tara to go with the consensus of the 2 drs-3 months will give you time to sort things out. Sorry to hear things aren't more clear cut for you- this is difficult enough w/o added frustration. Best of luck to you & we'll keep you in our thoughts & prayers!