Brain Aneurysm Coiling Mein Kya Hota Hai — Step by Step

Groin ki artery se brain aneurysm ka ilaaj — sunne mein ajeeb lagta hai. Yahan par detail mein samjhiye ki endovascular coiling procedure mein exactly kya kya hota hai.

Procedure Se Pehle

Patient ka MRI/MRA ya CT angiography hota hai taaki aneurysm ki location, size aur neck ki width accurately map ho sake. Blood tests, dawaiyon ka review (unruptured aneurysms ke liye aspirin aur clopidogrel shuru ki ja sakti hain), aur anaesthesia assessment poora hota hai. Procedure ek specialised biplane angiography suite mein hota hai — yeh ek aisa room hai jismein high-definition X-ray equipment hoti hai jo neurovascular kaam ke liye design ki gayi hai.

Step by Step Process

1. Anaesthesia: General anaesthesia diya jaata hai — isliye nahi ki procedure dard deta hai (dard nahi hota), balki isliye ki brain ki blood vessels mein delicate microcatheter navigate karte waqt patient bilkul hile nahi.
2. Groin access: Right femoral artery (groin) mein needle puncture se access milta hai. Ek patli introducer sheath lagayi jaati hai.
3. Guide catheter placement: 5–6 French guide catheter groin se, aorta ke through, carotid ya vertebral artery mein navigate kiya jaata hai — jo brain ke affected hisse ko supply karti hai.
4. Microcatheter navigation: Ek 0.017-inch microcatheter ko cerebral arteries mein carefully steer kiya jaata hai — yeh nasein 1–2mm jitni chhoti hoti hain — live X-ray guidance mein, jab tak uski tip aneurysm sac ke andar nahi pahunch jaati.
5. Coil deployment: Chhote platinum coils (0.010 inch diameter) microcatheter ke through aneurysm mein daale jaate hain. Har coil ki position aur stability check ki jaati hai, phir permanently detach kiya jaata hai. Multiple coils sac mein pack kiye jaate hain jab tak woh poori tarah se band nahi ho jaata.
6. Final angiogram: Contrast injection se confirm hota hai ki aneurysm blood circulation se poori tarah alag ho gaya hai. Parent arteries safe hain, yeh bhi confirm hota hai.
7. Closure: Groin access seal kiya jaata hai. Patient ko anaesthesia se jagaya jaata hai aur recovery room mein neurological assessment hota hai.

Kitna Time Lagta Hai?

Simple aneurysms: 1–2 ghante. Complex wide-neck aneurysms ya WEB procedures: 2–4 ghante. Ruptured aneurysm ke baad patient typically raat bhar ICU mein monitoring ke liye rehta hai, ya elective (unruptured) procedure ke baad regular ward room mein.