Residual Aneurysm and Angiogram

My aneurysm ruptured in 2021, and I underwent coiling for treatment. Doctors have different opinions on whether the residual needed to be treated, and I chose to observe. Recent MRA showed that the residual aneurysm has increased in size from 2.3mm to 2.7mm over the past year. With an international flight back to Asia scheduled for next Tuesday, the nurse suggested I undergo an angiogram on Monday for “peace of mind”. I’m unsure if it’s necessary to rush the procedure, I assume I will need some rest after angiogram, instead of embark on a 16-hour flight?

I would appreciate hearing about others’ experiences in making decisions regarding the treatment of residual aneurysms. Do I have to do a pre-surgery angiogram (which means additional risk and radiation) if I choose to undergo pipeline? I also read the new device “flow disrupter” such as Contour, does anyone have experience with that?

Thank you very much!
Grace

@Grace8
To have an angiogram the day before a long haul flight sounds ridiculous to me. What about all the possible complications that could happen after the incision in your groin? I would never ever do that.
That’s my opinion.

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Take to your nuerosurgeon. I had a rupture in 2021 with a SAH on May 22 had to have pupeline stent put in to divert blood flow from anerysn neck. Had tk stay on hospital 1 night. I was wiped out and exhausted for a few days. No way. I could handle noise and light

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Interesting that the doctors didn’t agree on whether or not to go back in. My coils compacted after the first procedure and six months later I was on the table for the second procedure. Risk of another rupture is significant as I understand it.

The only time I didn’t have what I call the “look and see” angiogram was when I ruptured and then my stent as the MRI showed her everything she needed to know. Each repair afterwards gifted me with an angiogram prior to the angiogram where my Neurosurgeon did another repair attempt. Usually the week before the repair. Six months later, I was on the table again for the next look and see angiogram. I’ve had o e or two without a repair to follow. So I think I’ve had a baker’s dozen angiograms total, maybe one more but BH isn’t up to ask. Some members haven’t had to have an angiogram with the repair being done at the same time. I think I know why the hospital I go to wants one done prior but I’m not positive. It is definitely a question to ask of yours,

Each angiogram repair was an overnight stay as @Angela3225 shared, the other ones I was able to go home after several hours. But just like @oct20 mentioned, what if something goes awry with the plug if they’re going through the groin? One of mine certainly did and I ended up with a huge hematoma. No way in Hades could I even be sitting up for a drive to see family down in Alabama or Georgia much less a flight that’s 15-20 hours long or more.

Logistically speaking would you or your surgeon really want you on a flight the next day? Does he or she really want you sitting up on such a long flight the next day? Has the RN ever flown on a long flight? I flew to DC from NC which isn’t much of a flight about three days after a repair and it wasn’t the most pleasant of flights. What about all the restrictions of weight, etc afterwards? I couldn’t imagine pulling luggage off the carousel so soon, nor carrying anything much on to the plane.

Would the procedure really give you peace of mind if done the day before? I get pretty excited once my toothbrush is packed so personally, I couldn’t do it. The farthest I’ve flown is across the States. The only jet that would have given me enough leg room was the nice double decker I was on when I joined the USN back in the ‘80’s and the plane only had a few dozen passengers. I’m only 5’ 2” according to the USN which gave me an extra ½”. I’ve flown first class many times and some of the planes are quite tight. When not in first class, the passenger in front of me always ends up in my lap when they recline fully.

Is the RN a NP? My Neurosurgeon has an NP as her sidekick. Ms. Ryann always staffs with Dr. Q-W before seeing me as well as afterwards. So I know what Dr. Q-W wants me to do. But if Dr.Q-W wants an angiogram, Dr. Q-W is the one I meet with. Before Ms. Ryann, there was another NP and I never saw her without Dr. Q-W.

I hope those who’ve had pipelines come on and share their experience. I have a different stent, Neuroform Atlas due to location and type of aneurysm. Can’t help with the Contour. But isn’t the type of device up to the surgeon? I know on my portal, I can send a message to either Ms. Ryann or Dr, Q-W. Ms. Ryann is really the one who reads them all. But if it’s straight to Dr. Q-W, those get staffed faster than if it’s to Ms. Ryann. Either way, the questions are always staffed, they make a wonderful team.

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The “peace of mind” suggestion to have such a procedure the day prior to a long-haul flight would not fly with me, personally.

It seems there’s a real possibility that the interventional radiologist’s report would not even be processed to your portal by the time you’d have to leave for the airport the following day. Even if it were, it’s likely there would be inadequate time for you to have even a phone consultation with your ordering physician to discuss the findings noted in the report.

Then, as others have mentioned, what if you are not feeling up to flying the following day? I presume you’d have to battle the airline to receive a full refund for your flight. That’s never a pleasant endeavor, even for someone who has not just undergone such an arduous test. And if there are other traveling companions on your itinerary, their last-minute flight changes could be even trickier to obtain.

While I certainly don’t want you to share any personal information you may not be comfortable discussing here, I am trying to wrap my head around “the elephant in the room”, namely, what is the nature of the trip? Is it a journey that could be postponed to a more convenient time when you can focus 100% on the purpose of your trip rather than having to be understandably concerned about various potential scenarios competing for your attention?

Since you are posting in English, I’m thinking that’s likely your native language. What if a delayed complication should arise once you arrive in Asia? You’d not even be on the same continent as your familiar medical team and your medical records in such a complex sub-specialty. And chances are there would be a language barrier, a complex insurance situation, or any number of other considerations that could make opting for this procedure the day prior seem like an imprudent course of action to consider should anything other than absolute perfection manifest thereafter.

My apologies that I have no experience with the Contour approach you raised. I’d like to know more about that from someone who does, once your primary decision has been addressed to your satisfaction.

Praying for wisdom and discernment for you as you consider this proposal that has been presented to you.

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Thank you so much to everyone for your incredibly helpful feedback! I eventually canceled the angiogram and was told that it was safe for me to travel for three weeks. I will take the angiogram when I’m back to the US. The reason for my travel is that my father is not doing well. He underwent clipping surgery 20 years ago and has been unable to live independently since then. Due to the COVID-19 situation, I haven’t been able to see him for over three years.

I have safely landed at my destination. I still have another domestic flight to take, but I’m feeling fine. I cannot express enough how grateful I am to have this forum :heart:

I inquired about flow disrupters like Contour because it appears that this new device does not require anti-platelet therapy like a stent does. This was a major concern of mine with regard to stent. It’s wonderful to witness the rapid development of technology in this field.

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How wonderful you get to visit your father! And you get to eat the foods you grew up with, which is always good! Have a great time and safe flight back!