Bahrain’s First: Management of Brain Arterial Aneurysm with Stents

Bahrain’s First: Management of Brain Arterial Aneurysm with Stents

Bahrain Specialist Hospital has successfully completed the first case of treating arterial aneurysm in the brain in the Kingdom of Bahrain under the supervision of the Nabeel Alshafai Neuro Spine Center. A brain aneurysm is a balloon-like swelling in the blood vessels of the brain due to weakness in the wall of the vessel. These aneurysms are prone to rupture (burst suddenly) and can cause a hemorrhage (bleed) in the space between the brain and its covering called sub-arachnoid hemorrhage. In the 1990s, coiling was introduced as a way of treating ruptured and unruptured brain aneurysms without the need for a craniotomy (an operation that opens the skull to expose the brain). Coiling involves approaching the aneurysm from inside the blood vessel so that there is no need to open the skull. A small tube (Catheter) is inserted through a small nick in the leg artery and navigated under the x-ray guidance into the brain artery; and from this catheter, a small microcatheter (less than an mm in size) is navigated and positioned in the aneurysm. Through this microcatheter, small metal coils are inserted into the aneurysm which stops blood flowing into the aneurysm and reduces the risk of bleeding. There are many shapes of spiral coils that are chosen according to the size of the aneurysm. A mesh backing may be used to keep the coils in place if necessary. Once the coils are in place, the interventional neurologist will remove the catheter and close the opening in the femoral artery. This case presented with a patient with a 7 mm aneurysm of the carotid artery and was treated with spiral coils using a catheter stent without any problems and the patient was discharged home the next day. This procedure is very delicate and takes at least 1-2 hours. Patients usually recover quickly and are discharged from the hospital the next day. Follow-up is carried out with each patient according to his/ her health condition. According to studies, catheter therapy is safe and effective for intracranial aneurysms. The operation was performed by a group of doctors under the leadership of Professor Nabeel S. Alshafai, Consultant Neurosurgeon, and the visiting doctor, Professor Timo Krings, Consultant Neurologist and Interventional Radiologist, University of Toronto, Canada.