Surgeons Treat Brain Aneurysms Through the Nose

Surgeons have discovered a way to treat brain aneurysms through the nose

Traditional methods of treating a ruptured brain aneurysm usually involve pretty invasive techniques, such as removing a piece of a patients skull, but surgeons at the University of North Carolina at Chapel Hill School of Medicine have found a new way to stop the bleeding – and they do it by going right through the nose.

In a report published in the March 2011 edition of the journal Neurosurgery, Dr. Anand V. Germanwala and Dr. Adam M. Zanation describe a case involving Alfreda Cordero, who was the first person to undergo this innovative surgery.

“It really pushes the entire field forward,” Zanation said in a news release. “This isn’t going to change all aneurysm treatment tomorrow, but it gets the ball rolling so we may provide an additional option to future aneurysm treatment.”

Instead of doing open brain surgery or endovascular coiling, which involves snaking a catheter through the groin up to the brain to stop the bleeding – surgeons opted to thread their tiny equipment through Corderos’ nose to reach the two aneurysms, which were located right behind her nasal cavity. The new approach is called “clipping the aneurysms through the nose.”

“It’s taking the best from the coiling procedure, because it’s minimally invasive, and taking the best from the clipping procedure, because it’s more permanent — and putting them together,” Germanwala said. “We’ve proved that it can be done safely, it can be done effectively, and we can treat multiple aneurysms. It is something we can certainly consider in the future.”

Two years later, Cordero is healthy, and the surgeons consider the procedure a great success. “Her recovery was remarkable,” Germanwala added.

A brain aneurysm occurs when there is a bulge or ballooning in a blood vessel in the brain, and it often looks like “a berry hanging on a stem.”

And while most brain aneurysms don’t rupture or create health problems, when one does, it can turn deadly very quickly. As for surgery through the nose, the surgical team has used a similar technique to treat brain tumors, but never for a ruptured aneurysm.

To view Corderos’ story, click here.

Penumbra Coil Recall…Aneurysm Device May Migrate to the Brain

The FDA upgraded the recall of the Penumbra platinum coil for treating brain aneurysms to class I due to the potential for the device to detach and migrate, which can lead to stroke.  The Penumbra Coil 400, a medical device placed in the brain to treat an aneurysm, has been recalled because the device may migrate inside the brain, causing a stroke, blood clot or even death. 

The Penumbra Coil 400 recall includes 267 lots — F17211 to F18553 — distributed in February 2011, according to an FDA statement.

The small coil is placed into a brain aneurysm by threading it through blood vessels leading to the brain. Once in place, a clot forms around the coil mass, occluding the aneurysm and protecting the vessel from ruptures or leaks.

The recalled device has a pull wire attached to an included tool used to implant the coil. The wire can slip and allow the coil to detach prematurely, migrating to unaffected areas to potentially cause serious injury, including blood clots and stroke, the FDA said.

The coil’s manufacturer, Penumbra of Alameda, Calif., initiated the recall on March 4, 2011 notifying customers and distributors of the problem by mail, with instructions to return the recalled product to the company.

The affected product was half-distributed in the U.S. and half-distributed internationally, the agency statement said.

Class I recalls affect products with reasonable risk of serious adverse events or death with use.

Any customers with questions can call Penumbra, Inc. at 510-748-3224. Any health care professionals or consumers who have experienced an adverse event due to Penumbra Coil side effects should report it through the FDA MedWatch Safety Information and Adverse Event Reporting Program.

When Life Takes the Unexpected Turn

You hear people say all the time that things happen for a reason…well this story is proof of that!   This past April, I traveled to Detroit to host Brain Aneuysm Awareness Night at Comerica Park, where I had the opportunity to address the crowd, throw out the 1st pitch and talk about The Joe Niekro Foundation.  I received a very gracious welcome and distinctly remember a specific group in the crowd that gave me a standing ovation after I threw the baffling Knuckleball across home plate.  A few days after I returned, I received an email through the foundation website from a man named, Mike, who had attended the game in Detroit.  He was writing to tell me he had learned that his best friend, Steve, had just suffered a ruptured aneurysm and was being treated at Barrow Neurological Institute in Phoenix.  Mike knew I lived in AZ, so was hoping that I could contact Steve and his family to gives my words of encouragement.  My numerous attempts to reach Steve wereunfortunately unsuccessful as he was allowed no visitors in ICU.  Mike and I stayed in touch during this time, as he provided me updates on how Steve was progressing.  Steve ended up spending over seven weeks at Barrow and was just recently released, but still under 24 hour care.  Flash forward to three days ago, when I received an unexpected and extremely welcoming email from Shellee.  Shellee, I soon discovered was Steve’s sister and was writing to tell me that she had gotten my name from Mike and was in town for the week, getting Steve adjusted to his new home away from home, the home that would be providing him with around the clock care and thorough rehabilitation for the next several weeks as he regains his strength and mobility.  Well yesterday, I finally had the privilege to finally meet Steve…and Shellee, and have to admit that yesterday made my entire year.  I had prepared myself for the worst, as I wasn’t sure of Steve’s current state, but was so relieved to find Steve copping a big smile and determined to overcome the challenges that lie ahead.  Steve’s courage is beyond words and his perserverance is unstoppable.  We talked for hours, sharing baseball stories, reliving the day of Steve’s aneurysm and putting together the plan of attack on how Steve is going to beat the enemy we know as  aneurysms.  I am committed to Steve’s recovery, just like he is and can’t wait to talk to him again.  So, last night as I lay my head on the pillow to go to sleep, I thanked the Lord for bringing me to Mike, Shellee and Steve.  The future ahead is a bright one and I look forward to this beautiful new friendship…one that was brought together by an unfortunate tradegy, but will thrive forever through our shared passion for life.    Mike, thank you for finding me.  Shellee, thank you for reaching out and Steve…thank you for… BEING YOU!

Natalie and Steve...Knuckling up for Aneurysms!

Latest Technology Treats Brain Aneurysm

I must share with all of you this fascinating new procedure that will help save thousands.  This treatment, most recently performed by Dr. Diaz and Dr. Klucznik, neurologists at The Methodist Neurological Institute, is the ground-breaking treatment method to beat the enemies we know as aneurysms.  Take a look at this amazing video and see for yourself this incredible advancement in neurological research:

Onyx 500 Treatment for Aneursyms

New Aneursym Treatment Method Involves Liquid

The development of aneurysm research has expanded.  The FDA has recently approved a liquid material called Onyx 500 that will join clipping and coiling as the methods of treating aneurysms.   This procedure is less invasive than the traditional open skull surgery or platinum coils, and  involves threading a catheter through the patient’s groin area and blood vessels and up to the brain.  Then Onyx HD 500 liquid is then administered to the aneurysm, instead of the traditional coiling method.

When the Onyx 500 liquid makes contact with blood inside the bulging aneurysm, it becomes a firm pudding-like substance and works like concrete to stabilize the aneurysm and prevent more blood from entering and causing it to rupture. It is most effective with irregularly-shaped intracranial aneurysms where open surgery or coiling alone wouldn’t be able to do the trick.

In 20 percent of patients whose brain aneurysms are treated with coils, the surgery must be redone because the coils shift and blood re-enters the bulge.  This new treatment method certainly offers neurosurgeons an alternative when it comes to treating aneurysms, and is certainly less invasive for the patient. 

This just shows that the funding of aneurysm research is vital and great things are being done when you help the cause.  Thank you for being part of the fight with me.

A Breakthrough in Aneurysm Treatment

Today, I had the great opportunity to speak with Dr. Nasser Razack, the director of interventional neuroradiology at Bayfront Medical Center in St. Petersburg.  Dr. Razack is one of the first in his field to perform a new treatment method for aneurysms that uses an Elmer’s Glue-like substance called Liquid Onyx to fill aneurysms, therefore preventing them from rupturing.  This is the latest tool for a new breed of doctors trying to fix life-threatening conditions in the brain without brain surgery. The new substance, Onyx HD500, is a liquid that can be used to treat an aneurysm, a weak spot in a blood vessel that balloons.

Such aneurysms can be deadly if they burst, and they are hard to treat without damaging the brain or critical blood vessels. Doctors inject Onyx into the aneurysm, where it quickly solidifies, cutting off the area’s blood supply.

The doctors using such tools go by the lengthy label “neurointerventionalists.” Just as interventional cardiologists brought new techniques a generation ago, replacing open-heart surgeries with stents to open arteries, these doctors bring minimally invasive techniques to the brain.

“It’s such a relatively new field that it’s very hard for people to understand it — that you can take a very small catheter and snake it into the brain,” said Dr. Nasser Razack, .

Razack has a simpler way of telling people his job. He calls himself a “plumber for the brain.”

Razack, Tampa General’s director of neurointerventional radiology, is among about 300 such specialists in the country. The field is so young that a national group representing such doctors just held its first independent yearly conference in 2004.

But the group is rapidly finding new ways, like Onyx, to treat brain disorders. Neurointerventionalists are pioneering treatments for stroke that include injecting drugs and using tiny tools to remove blood clots. The doctors also have developed other ways to treat aneurysms and tangles of blood vessels in the brain that cause seizures and headaches.

Their chief weapon is the microcatheter, a tiny tube that can be inserted into a blood vessel and guided to the brain, where it can be used to inject dye or drugs, inflate a balloon or pop out a tiny space-age tool.

During the procedure, doctors feed a catheter through an artery in the leg, up into the brain. The glue is slowly injected into the aneurysm and hardens in place. A balloon protects the rest of the brain from the glue and seals the aneurysm shut.

Today’s conversation was one of hope and encouragment, re-enforcing my mission of the Joe Niekro Foundation.  Breakthroughs such as this are what will being to save thousands of lives every year.  However, our destiny is still in our own hands and there are definite risk factors related to aneurysms, so be good to yourself, your health and your body….because you never know when your last day will come.