I had an uneventful angiogram last week at Maine Med which is good. It’s probably not a good thing that I’ve been to the radiology department so often over the years that many of them remember me, but it is what it is.

As I was still laying on the angio table after the procedure Dr. Ecker informed me the good news was that there were no new brain aneurysms and the clipped aneurysm from last year looked great. However, there was that pesky “remnant” on the neck of my original annie that he needed to review from previous images and we’d discuss it this week.

So, I went in to his office today for the follow up appointment and finally got to see the images of my clipped aneurysm and the “remnant” in question on my original brain aneurysm from 2006.

I missed getting a photo of the 3D images, but I snapped the photo below from the angiogram last week. It’s a straight on shot looking at my skull from the front. You can see my eye sockets and the large black mass in the middle of my eyes is the 1/2″ diameter (11mm) aneurysm from 2006 that now has 20 platinum coils in it. If you then look to the right, you can see the clip that was placed at the neck of the smaller aneurysm, which is no longer there. The clipping was a huge success. I thought this visual was pretty neat…and scary looking with that black blob there. Can’t see the arteries in this image because they’re only visible when the contrast dye is injected.

Yet again, I am faced with three potential treatment options:

1. Do nothing. Have another angriogram in another year and see if it changes size or shape. It may stay the same size for the rest of my life. We just don’t know. Watch and wait.
2. Re-coil. Insert more coils through the stent into the remnant to fill that up again. This may, or may not be a durable, more perminant option and may require more procedures later…or it may not.
3. The Pipeline. This is a relatively new, but highly successful option for those wide-neck, large, difficult to operate on brain aneurysms. Dr. Ecker has done 40 of these procedures in the last two years with very good results. I also know another survivor from Florida who has had the pipeline and she’s doing great.

The pipeline is a different type of stent. The issue with my particular case is that the pipeline would have to be deployed inside my existing stent. We’re going to investigate how successful that could be or if it has even been done before.

That’s what I have to think about now. Nothing life threatening, but it could be….or it couldn’t be. It’s that uncertainty that I always hate. At least I know what’s going on and what I have to deal with and my treatment options. Currently I’m leaning towards waiting a year, but at the same time I’m thinking if I took care of it with the pipeline while I’m still relatively young and mobile and have a job and good insurance…I should take advantage of all of those things that are in my favor. I just don’t know. That aneurysm is in a bad spot, sitting on my ocular nerve. If something were to happen during a procedure that effected my eyesight, I may not be able to work or drive anyway….OH, the scenarios that play out in one’s mind!

I know Dr. Ecker wouldn’t guide me in a direction that would potentially pose a serious risk and that his recommendations are based on the experiences he and the fantastic staff at Maine Medical Center Neurology have encountered. I will rely on their expertiese, even though I’ve grown far more knowledgeable than I ever thought I would become about brain aneurysms. The pesky big aneurysm is testing my patience, yet again.