Repair of aneurysm with "pipe line" procedure

I have never posted here before and am not sure I am doing this properly! My two aneurysms were discovered in 2008, but when radiologists looked at previous MRIs of my head they admitted that the aneurysms had been "overlooked" before, so not sure how long they have been present. To date there has been no treatment, only "watch and wait". One is too small to be treated but the other is 7 mm, so right on the bubble (no pun intended) of the size at which doctors feel treatment is or isn't required. This aneurysm has not changed in size, but the doctor now feels that since the chance of rupture increases with each passing year, now is the time to repair it. He wants to use the new"pipe line" repair procedure. I am having a difficult time deciding if I want to do this! Has anyone had this procedure and if so, what can I expect during and after? Any input would be enormously appreciated!

Shirley...that all depends on the explanation to you of the procedure...and access to the aneurysm...

I recently posted the strokeSTOP...which provides the anatomy of the brain structures supported by the arteries...and, what your doc explained about your artery location and its name/segment of the aneurysm...

There is also a Group site that has been active soon after the promotion of the new pipeline...I am sure there are many active members in that Group...

Wishing you best in your decisions...and, please update us...

I was also told that the chance of rupture increases with each passing year, but I am delaying due to health issues. Mine is 8mm in the anterior communicating artery, which is supposedly less likely to rupture.

Do you have more information? Where exactly is your Annie?

Lol, I found info that Annies in both the posterior and the anterior ACom were about equal in the chance of rupture.

You might want to read this: https://www2.rsna.org/timssnet/media/pressreleases/pr_target.cfm?ID=679

Since it has been six months since my brain scan, I may ask for another to see if my Annie is growing.

Patio,

I think I found the information that there was equal chance of rupture on a Japanese website.

There is too much contradictory information on the web, which makes it nearly impossible to make an informed decision. And sharing can be problematic, because anyone of us could be innocently misleading.

One site calls my Annie at 8mm “small,” another designates it as “medium.” One site says anything over 7mm should be addressed, another says 10mm.

Campanile...I ma such a slow read...yet...I am back a second time...in reading "posterior"...I now think you mean PCOM (posterior communicating?) ...and, it makes so much sense...I stumbled because 'posterior' is used in so many diff ways / places...

And, in my slowness...I think you mean PCOM and the circle of Willis...

I am in the process of learning from the strokeSTOP...where the PCOMs connect to the posterior cerebral arteries (PCA) P2 segment...... .

Pat

That is one reason I have been so pleased in the strokeSTOP...UMass Med School and American Stroke Association...and copyrighted...even tho it has limited aneurysm data ...the rest is so easy to comprehend... re: the pressures / pain, emotions, cognitive malfunction; auditory and visual issues... even when they are not areas usually supplied by the artery hosting the aneurysm...

Or the growth/ pressure of the aneurysm...where its body begins to affect other structures... and, the gray matter and/or white matter...'cuz those are in our brain to help guide / do the sensory (nerve) connections to /between the structures... (almost in a sense (my tangled interp)...gray and white matter are somewhat structures themselves???...I have not yet found it in research that they are called "structures"... they may be) ...


Campanile said:

Patio,

I think I found the information that there was equal chance of rupture on a Japanese website.

There is too much contradictory information on the web, which makes it nearly impossible to make an informed decision. And sharing can be problematic, because anyone of us could be innocently misleading.

One site calls my Annie at 8mm "small," another designates it as "medium." One site says anything over 7mm should be addressed, another says 10mm.

What do you mean by a |"Pipeline procedure"?



patioplans said:

Shirley...that all depends on the explanation to you of the procedure...and access to the aneurysm...

I recently posted the strokeSTOP...which provides the anatomy of the brain structures supported by the arteries...and, what your doc explained about your artery location and its name/segment of the aneurysm...

There is also a Group site that has been active soon after the promotion of the new pipeline...I am sure there are many active members in that Group...

Wishing you best in your decisions...and, please update us...

I am still having trouble figuring out how to use this discussion group, so hope I am replying properly. it has taken me three weeks to figure out how to access this discussion group again once I had originally posted! I am usually more computer-savvy than this!

To update:

I had a CTA last week, and met with the neurointerventionalist yesterday. He says there is actually a third aneurysm now visible which is right next to the 7 mm one one the ophthalmic and carotid artery. I asked a lot of questions, and he admits that repair is a decision I must make, as the size of the largest aneurysm is right at the size that makes the decision kind of "iffy". If it were bigger, it would definitely need to be repaired now; if it were smaller, there would be less need to repair. The addition of another one is making this decision even more difficult for me! I have survived leukemia, live with a chemo-damaged heart, thyroid, and kidneys, and have Lupus. I lost my brother, uncle, aunt and grandfather to ruptured aneurysms. This is such a difficult decision. I am concerned with the risks, and wonder how I will feel after the procedure. I don't have any symptoms from the aneurysms so it is hard to put myself through the surgery when I am managing so well right now with all the other health issues. I don't want to 'rock the boat' but also don't want to put off the repair simply because I am afraid.

Shirley..my heart goes out for you...for all that you have survived...and, of the losses of your family with aneurysms.

I can so well understand/ share...getting into a new site...and, being confused; today I have been "interrupted"...with the news covering a major multiple vehicle accident...and, my thought process was/became misaligned..

You do have a big decision...you note the one (or 2) was diagnosed in 2008 and growth being monitored...and, another discovered...

My only odd question on that is what was the reason, symptoms or family history for the initial testing/diagnosis?

Regarding your overall status, depending on when you had your cancer or any other treatments...do you have a neurologist/other specialist you can also talk with on your next step / decision? RE: the timing of your prior procedures, any drugs you take, then to having this other new treatment. Did/do you have a neurologist /other specialist you can discuss more with?

Did the doc you saw yesterday address with you the drugs you would/will be placed on during the procedure...and, if any recommended days or weeks to treatment?

Prayers, you also have some family and/or close friends who will help you in your discussion too, and, or be with you during your doctor visits...and that you do keep us updated... patioplans

My first two aneurysms were found incidentally when my neurologist ordered an MRI to determine if there was an organic reason for the increase in frequency and severity of the migraines I have had my entire adult life. He was also concerned that there might be damage from the TIAs that I occasionally suffer as a result of my heart damage and from the antiphospholipid syndrome that is part of the joy of Lupus! Despite having a family history of aneurysms, it actually never occurred to me that I might have one (or more!) The doctor I saw yesterday is aware of my health history and the numerous drugs I take for treatment and control of the heart damage, thyroid damage, kidney damage, and Lupus. He said I would be taken off of Coumadin and put on Lovenox - which I am familiar with as I was given that last year when I had rotator cuff surgery. I will also have to take Plavix (?). I have been cleared by my cardiologist with regards to being able to withstand the anesthesia and surgery. I will be getting a second opinion from a neurointerventionalist at Yale New Haven on October 15th, and my doctor here is aware that I am doing so. I am a patient advocate, so there is no way I would make this decision without practicing what I preach - which is always gather as much information as possible (from reliable sources) and when appropriate, get a second, or even third opinion so that you are as sure as possible that you will be receiving proper treatment/care. I am also blessed with a very supportive husband and family. My husband has admitted that he is leaning toward my having the procedure done, as he has been worried about rupture ever since we first learned of the aneurysms. And with the revelation that there is now a third aneurysm, he feels that we need to take action. My children are withholding their personal opinions until I have seen the second doctor. Obviously my fears are based on the risks - the most severe being stroke, or rupture of one of the aneurysms during the procedure. I really wish I could talk with someone who has had this done so I would know how I will feel after a 'successful' procedure! I have been told for the past 8 years that I am a 'high-risk' patient for surgery because of my other health issues, so that factors into my fears also. If I do find the courage to do this, it would not be until January. Should there be any complications, I do not want to miss out on the holidays, and that is when I get to see all of my children, their wonderful spouses, and my beloved 13 grandchildren! I don't know if my age is a factor in this whole matter. I am only 69, and a very young 69 at that - very active and healthy despite my various health issues. Thank you for responding and helping me. I will be checking out the Group that you mentioned.