Today, we set date for Endovascular Treatment (Flow Diverter) for July 17th. My annie is 4 x 6.2 and due to the odd/rare shape and how it connect to the opthalmic artery that lead to my left eye, this is the best option FOR NOW! Clipping is not on the table right now as I am on Plavix and Aspirin and they don’t believe Cardiology will agree to stopping either one. I understand this as if they clip the annie, I may end up having a heart attack and Cardiology will likely say “hell no”. Next month will be a year since my heart stent, so there is a possibility I may have been coming off next month but there is no guarantee. On the other hand, since aspirin and Plavix is required for the flow diverter with a requirement for up to at least 6 months, there is a possibility the overlap can give Neurosurgery leverage to level off the aspirin and plavix (only for a couple of weeks for prep and until surgery is over) by that time and do the clipping IF the aneurysm is still active.
As I discussed with my Neurosurgeon, my goal is to control/manage this annie ASAP using the best treatment with the best outcome. He said with my annie there is a 0.5% chance of rupture over the next year. My annie as stated above is oddly shaped which is complicated in terms of risking vision loss. The annie itself is like a bubble but the neck is like a double bubble. It look like a hand is clasped over the annie and it is directly connected to the opthalmic artery. I told my husband that is God’s hand holding my annie! Coiling is off the table as if they filled it with coils, they could possibly fall out and if it clot that clot could easily travel in either direction and cause a stroke. I am comfortable with what we have planned as this is the best option for right now until we can do a clipping, if needed. He indicated there was a good chance the annie could shrink. He said, the primary goal of the flow diverter is to take the pressure off the annie which will ultimately reduce the chance of rupture. I am in good hands with some of the best doctors in the country and I trust their recommendation. Hubby took notes so if I forgot something I will post later once he type them out for me as I cannot read his “doctor” style writing. LOL
ETA: The names of the flow diverters he mentioned are Surpass and Pipeline
I had coils 2005, 2007 stent and coils, 2009 coils. This past January I had a pipeline put inside the original stent. I just had an MRA last Friday. My aneurysm finally occluded after 14 years with the pipeline. My doctor said if they had the pipeline 14 years ago I would have had it put in and been done. He said he thinks I have the record for the most coils (90 plus), MRA, and angios. My aneurysm is very large on my carotid artery in the sinus cavernous area. It could not be clipped re the location. The first stent was put in to keep the coils falling out into the carotid artery because the neck was so large. I have been on plavix and asprin for 14 years. Each angio or procedure I have to be off 7 days prior. I hope your stent is a the one only procedure you have to have.
The neurosurgeon did mention that if the annie does not occlude, adding an additional stent inside of the first one would be an option. As I stated above, by that time, Cardiology should be willing to allow me to stop the aspirin and plavix for two weeks prior of doing a clipping or Neurosurgery will leverage the authority to remove me for that prep time.
Why do you have to stop your plavix and aspirin regimen 7 days prior to angio/procedure?
Yeah, they add heparin to make sure there are no clots. The P2Y12 test that shows increased risk of bleeding is one of the labs ordered for my Pre-op testing.
Completed Pre-op yesterday and is all set for procedure on Wednesday. Ironically, I also had my 1st year post heart stent follow-up with Cardiologist and he discontinued the Plavix & aspirin regimen but since I have the procedure coming up I have to remain on the regimen. He said once the neurosurgeon give the ok to end the regimen, that will be it for that. I highly doubt it because of the stent placement. Hopefully, the stent will occlude the annie, if not we now have the discretion to stop the Plavix/aspirin regimen and proceed with clipping, if necessary. Aside from that, I am looking forward to getting this resolved.
Edit: Forgot to mention, after the Pre-op, I am participating in a research study that looks at the formation of blood clots in the vessels before, during and after Pipeline treatment. While laying in a bed they place this device over my head with some sensors/microphone and they listen and view the ultrasound for an hour measuring blood flow to the arteries in the brain, summarily looking for clots. Fortunately, none was found for me. The next round will be after the procedure, the next day before discharge and when I return for groin-wound check and follow-up. I am happy to contribute to whatever research that will help endovascular treatments.
I’ll be thinking of you on Wednesday. I do hope this procedure takes care of the aneurysm.
And, thank you so much for volunteering for the research!! I’ve done something similar because I know without research I wouldn’t be here.
It’s kind of a funny story. My participation was a long time ago. I was having a mammogram and was asked if I’d be part of a research study concerning new digital tech. Of course I would! Unfortunately for me…that meant two seperate mammograms!!! Lol!! They didn’t tell me that at the beginning!! And so glad I participated.
Good luck and you will be in my thoughts during that time. When you get a chance…let us know how you’re doing please.
Mary
