Jolanta told how brain aneurysms ruptured: treatment applied for the first time in Lithuania saved

Healing equals a miracle

“It just came to our notice then. I turned to the neighbor, came home a few minutes later, and my butt, like someone had hit me hard on the head, recalls Jolanta, who had a brain aneurysm ruptured in the spring 2017. – It was very unexpected, because I felt good until then. After the “hit”, I just went to bed and went to bed, my consciousness disappeared, it reappeared, I was sick, I was vomiting. Fortunately, there was a man at home , asked for help. When the paramedics arrived, they took me to the Vilnius Republican University Hospital (RVUL) as soon as I could. I remember so much that before the operation, Dr. Afanasyev told me: “Jolanta, we will help you.”

Three weeks after the successful embolization of her brain aneurysm, Jolanta left home, then underwent rehab and returned to work. “After a year I had to investigate, the results were good. But at the beginning of this year, I began to suspect something, it did not hurt at all, it was always accompanied by a strange and difficult to describe feeling in my head, so I turned to doctor A. Afanasjev. It turned out that the aneurysm embolized two years ago started to grow back. In late April, the doctor implanted a stent (a small mesh tube) in the damaged blood vessel in his head. Only 3 weeks after the operation, I was able to go back to work, ”continues Jolanta.

When asked how she feels, the woman smiles and says that the doctor gave her life and maintained her ability to work: “Although I work in the hospital myself, it is a miracle for me, I am extremely grateful to the talented doctor Afanasyev and I cannot express it with any words. “

Through the groin to the brain

A. Afanasjev, Interventional Radiologist in RVUL’s Department of Interventional Radiology, sees the story of patient Jolanta as not a miracle, but a medical advance: the constant improvement of interventional radiology provides the opportunity to treat patients with ruptured aneurysm quickly, efficiently and minimally invasive. “Jolanta was taken to the Emergency Department. After performing a CT angiography of the brain, we saw that the aneurysm ruptured. In such cases, two treatments can be used in Lithuania: open surgery to reach a blood vessel through an opening in the skull or a minimally invasive operation called aneurysm embolization – we choose the latter.

The operation is performed through the groin; With the help of X-rays and contrast material, we can travel through the arteries to the site of the damaged blood vessel, and it is usually blocked. The operation should be performed as soon as possible, as the risk of the aneurysm rupturing again increases over time, thus significantly increasing the chances of death. It is the treatment methods used in interventional radiology that allow us to act quickly and precisely: after evaluating the CT scan and locating the aneurysm, we draw up a treatment plan and start working immediately – on thoracic surgery to the few minutes from the blood vessels. Furthermore, interventional radiology methods for treating aneurysms can be applied to almost all patients, ”says Dr. Afanasyev.

He adds that neurointerventional radiology has more advantages: the operation takes less time, the patient is discharged from the hospital in just a few days and returns to a full life faster. In addition, according to the doctor, there is a kind of competition in this field of medicine: interventional radiology devices and tools are improved almost every year, so that patients can be treated more efficiently and quickly.

Used in Lithuania for the first time

An aneurysm is a disease of the blood vessels, which means that the entire segment of the blood vessel in which it is present may be weaker and more damaged. As a result, patients are monitored and inspected annually or more frequently after aneurysm embolization. “After Jolanta’s condition, this year we noticed changes in the blood vessel that could turn into an aneurysm in the future, and we decided to implant a stent, a current divider that connects two intact vascular segments and strengthens the damaged part of the blood vessel. between them, “he explains.

He highlights that a very small stent has recently been developed, which can be “transported” to the brain through an extremely narrow microcatheter approximately half a millimeter in diameter: “This new type of stent was used for the first time in Lithuania by our team during Jolanta’s operation. The stent is very convenient because it is easy to navigate; remember that we have to “transport” it from the groin through the inserted microcatheter to the site of the damaged blood vessel in the brain. The blood vessels of the human body are not arranged like straight tubes, they are curved, so we have to overcome those curves: the smaller, thinner and easier to implant the stent, the more comfortable and safe this procedure is. Once in place, the stent dilates, envelops the damaged segment of the blood vessel and prevents the pressure of blood flow and the formation of a new aneurysm. It may seem from the outside that parts of a millimeter do not mean anything, but they are very important in our work ”.

When asked if Jolanta’s problem has been fully resolved, Dr. Afanasyev says the woman will need testing in 6 to 12 months, but says current shunts are one of the most effective treatments for aneurysms: their effectiveness is 90%, they significantly reduce aneurysms, the risk of rupture and prolong the life of patients with cerebral aneurysms. The surgery is minimally invasive, so a person can be discharged from the hospital in just a few days and soon return to a full life.