We are currently coiling/embolizing the majority (>75%) of aneurysms at PNC. There are still some aneurysms with unique shapes not suitable for coiling. The FDA just approved a new coil which is platinum with a thin protein coat on it. This induces actual endothelial growth/lining at the base of the aneurysm which seals it from the main blood vessel permanently. Early results are very exciting, and this will dramatically improve long term aneurysm obliteration. Additionally, the FDA has also approved a new soft intracranial stent for assisting the treatment of wide neck aneurysms. These new developments are sure to continue towards our goal of treating over 90% of aneurysms without craniotomy.

UNRUPTURED ANEURYSMS

Which ones to treat:
We are treating unruptured aneurysms as little as 2 mm in size. While the average size of ruptured aneurysm is about 7 mm, it is not infrequent that we treat 2 and 3 mm aneurysms. The complication rates for treating unruptured aneurysms is about 1 - 2%. These patient come in first thing in the morning, the average embolization takes about 2 hours. They are kept overnight in our Neuro ICU for observation and go home the next morning. The majority of our patients with unruptured aneurysms get a non invasive work up (>90%). We perform high resolution 3D animated MRA for presurgical planning. Their diagnostic angiogram is done at the same time as the embolization. This is in contrast to the majority of centers which perform a separate invasive diagnostic angiogram prior to treatment.

STENTING UPDATE . . .CAROTID AND INTRACRANIAL

We provide full service cerebrovascular assessment and treatment for revascularization of the blood vessels of the head and neck. PNC was the first center in the Northwest to offer Carotid Stenting with Distal Protection (Balloon). Carotid Stenting is still not an FDA approved procedure, and therefore we do these procedures as part of a trial under the auspices of an investigational review board. Those of us performing the procedure are fellowship trained not only in the procedures, but also have extensive training and experience in understanding in which patients would best benefit from stenting, and which patients would not. For selected patients with less common intracranial stenoses – we offer angioplasty and stenting of the intracranial vessels including the internal carotid arteries, vertebral, basilar, and middle cerebral arteries.