Patient Glad UAMS Has Latest Aneurysm Treatment

May 21, 2012 | Tony King of Texarkana is among a growing number of aneurysm patients thankful that the University of Arkansas for Medical Sciences (UAMS) offers the latest minimally invasive aneurysm treatments and is one of the few medical centers in the country with the Pipeline Embolization Device.

(L-R) Tony and Melissa King are thankful for the highly specialized skills of UAMS' Eren Erdem, M.D., who treated Tony's five brain aneurysms over a 10-month period.

King, a law enforcement officer, remembers being told at his local hospital that his sudden left-eye blindness was caused by an aneurysm and that his odds of surviving the three-hour ambulance ride to UAMS weren’t good.

An aneurysm is caused by weakening of a blood vessel’s wall. It appears as a balloon-like bulge from the side of the vessel and can burst at any time. Aneurysms that burst in the brain cause hemorrhagic strokes, the most deadly type of stroke.

King’s aneurysm didn’t burst, but it was applying pressure to adjacent nerves that caused his temporarily impaired sight. When he got to UAMS, King, 52, was in for another surprise: Doctors discovered that he had four additional aneurysms, an extremely rare occurrence.

“I’ve had friends pass away from ruptured aneurysms,” King said. “But UAMS gave me hope. After I got here and was ready for surgery, the doctors said, ‘We’ll see you when you wake up.’ I just thank God that UAMS is here and has doctors who can help patients like me.”

Led by UAMS’ Eren Erdem, M.D., an interventional neuroradiologist, King underwent three aneurysm procedures over a 10-month period. All of the procedures were done endovascularly, meaning the aneurysms were treated from within the blood vessels. This method involves inserting a catheter into a major blood vessel near the groin, and from there it is threaded all the way into the brain.

In King’s first two procedures, thin wire-like material known as coils were pushed into three of King’s aneurysms. The coils filled the space inside the aneurysms and shut off blood flow into the aneurysm. Coil Embolization, as it is known, became a standard aneurysm treatment in the 1990s.

King’s final two aneurysms were treated using the Pipeline Embolization Device, which received the federal Food and Drug Administration’s premarket approval in April 2011. Resembling a tiny cylindrical spring, the device is composed of 48 braided strands of cobalt chromium and platinum tungsten. From within the vessel, it is placed over the aneurysm using a micro-guidewire and a micro-catheter. Working somewhat like a stent, the flexible device fits snugly against the inner walls of the vessel to shield the aneurysm from blood flow. The device forms a scaffold upon which endothelial cells can grow. Eventually the cells cover the implant, including the neck of the aneurysm, which seals off the aneurysm.

Under the FDA’s guidelines, the device can be used only for certain large or giant wide-necked intracranial aneurysms.

“The Pipeline Embolization Device is very exciting and opens a new era for us in the treatment of aneurysms,” Erdem said. “While its use is currently limited to certain types of aneurysms, we anticipate that use of the device will soon be expanded for aneurysm treatment in other parts of the body.”

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