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Aneurysm

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Having one of the most experienced teams of physicians and medical professionals in the treatment of aneurysms, the University of Miami Health System has earned a world-class reputation. We offer a range of treatment options, including the use of minimally invasive techniques like aneurysm coiling. In addition, we have a 24-bed neurosurgical intensive care unit that includes a multidisciplinary aneurysm support group to address the social and psychological needs of patients and their families.

Cerebral aneurysms are caused by a weakening in the artery walls that causes the vessel to swell in response to the blood pressure on the walls. Aneurysms may compress the surrounding tissue or cranial nerves, resulting in various neurological symptoms, depending on the affected brain area.

Since the vessel walls of aneurysms are weak, they are at risk for rupturing. If this happens, then a subarachnoid hemorrhage (SAH) occurs. SAHs are fatal in 40% of cases; therefore, it is crucial to identify aneurysms and treat them before they rupture.

Many cerebrovascular conditions, including aneurysms, can lead to the need for emergency surgical intervention. In fact, cerebrovascular disease is the third leading cause of death in the United States.

That is why you want the best doctors in the field at your side and in the operating room.

Tests

Computed Tomography Scan (CT or CAT scan)
This diagnostic imaging procedure uses a combination of x-rays and computer technology to produce cross-sectional images of your brain. CT scans are more detailed than general x-rays, are used to detect abnormalities and can help identify the location of an aneurysm.

Magnetic Resonance Imaging (MRI)
This diagnostic procedure uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. An MRI uses magnetic fields to detect small changes in brain tissue that help locate and diagnose aneurysms.

Computed Tomographic Angiography (CTA)
A CT angiogram uses CT technology to obtain x-ray images of blood vessels.

Magnetic Resonance Angiography (MRA)
This noninvasive procedure evaluates blood flow through arteries using MRI technology.

Treatments

Coiling
Coiling, or endovascular embolization, consists of placing micro-coils in an aneurysm via a catheter to close off blood flow and thus prevent rupture or stop bleeding. Micro-coils are shaped like a spring and made of platinum. They are tiny, ranging in size from about twice the width of a human hair to less than one hair's width. Coiling does not require a craniotomy and is performed under light sedation or general anesthesia. Generally, the hospital stay (1-3 days) is half that of more invasive procedures.

Stenting
Stenting is performed by placing a pipe-shaped metal mesh inside the blood vessel to cover the neck of the aneurysm. The stent is placed before coiling and remains in the artery permanently to hold the coils inside the aneurysm, preventing them from falling out. Over time, blood clots on the coils and diverts blood away from the weakened vessel walls and prevents a rupture.

Mechanical Thrombectomy
During a mechanical thrombectomy, the surgeon removes the clot that is obstructing blood flow to the brain using sophisticated instruments called retriever devices. The procedure starts with inserting a catheter into an artery in the leg, which is then guided through the vascular system into the obstructed vessel in the brain. The clot retrieval device is then passed through the catheter to the blood clot, where it captures and removes it.

Craniotomy
A craniotomy is an intricate neurological procedure performed by opening the skull, performing the needed operation and closing the skull by securing the bone into its original position. We offer our patients the best care and access to neurosurgical innovations that you only see at leading academic medical centers.

Why Choose UHealth?

The University of Miami Cerebrovascular Initiative (UMCVI). UMCVI was created to provide world-class care to patients afflicted with complex cerebrovascular diseases and to conduct cutting edge cerebrovascular research. Our cerebrovascular and endovascular specialists set high standards and meet them through the expertise of highly skilled neurosurgeons and clinicians, state-of-the art endovascular and surgical procedures, and pioneering research.

Minimally invasive endovascular and surgical repair. It is now possible for us to treat damaged vessels without the need for open-skull surgery, resulting in better outcomes and shorter recovery time, when compared to open surgeries. This is due to advances in minimally invasive endovascular/cerebrovascular surgery.

3-D computer modeling. We use this to assist in the treatment of difficult and rare aneurysms. A dye is injected into arteries to track blood flow. A computer superimposes that information over brain scans to compose a 3D model of the aneurysm and the blood flowing through the arteries to the aneurysm. By using this technique, surgeons can test if different surgical techniques would alter blood flow enough to ease pressure inside the aneurysm.

Multidisciplinary team. At UHealth, you have access to the best neurosurgeons in the region. You will be taken care of by a passionate and knowledgeable multidisciplinary team of medical professionals who make sure that you receive the right treatment for your unique condition.

Minimally invasive craniotomies. The neurosurgery team at UHealth provides treatment designed to offer the best outcomes while minimizing side effects for our patients. That is why—whenever possible—we perform minimally invasive craniotomies with the use of the most advanced technology available.

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