Category: Medical Procedures

MRA Results and New Doctor

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Today I met the new aneurysm doctor here in Maine, Dr. Ecker, and got the results back on the MRA of my annie.

Dr. Ecker is a real straight shooter and got straight to the point: The MRA showed a slight recanalization of the coiling in the aneurysm. That was a term Dave and I had
never heard, so Dr. Ecker took us to his office, showed us the MRA results and drew us a diagram on what was showing up on the MRA and what his concern was.

I’ll try to explain it without drawing it! Basically, either the aneurysm has slightly grown, or the coils have contracted and it has allowed some blood to flow into the aneurysm through the neck of the aneurysm. His words were that I had a “recanalization of the neck”. Of course, I was initially shaken. My fear has always been they’d discover another annie, not having an issue with my existing one, so this was a
surprise to say the least.

He wants me to have an angiogram now.mDr. Ecker said it wasn’t an emergency situation, so we’re waiting until January, after the holidays for that. He does the angiograms, he also does coiling and clipping operations. I’m thrilled he’s here in the state of Maine. He also appears to have experience with the by-pass surgery I’ve just recently read about.

Right now, there is no course of action until after he see the arteries and coiling on the angiogram. Right now, all of the things he mentioned were “if this….”, or “if that….”, so we need to see the results of the angriogram. Dave has done a lot of research online since we got home and is discovering it’s not that highly UNcommon for this to happen. Usually the recanalization occurs within the first two years after the coiling, so this is kind of unusual, but I feel confident Dr. Ecker will give us the best course of action. He’d either have to go in and insert more coils, which I’ve read several people have had to do on the message board, there’s a possibility I could have to have it clipped, which is a more serious operation, or he’d insert a stent inserted to block off the flow off blood there. Again…he can’t tell for certain what needs to be done until we do the angiogram.

He studied in Buffalo, was in the service as a medical surgeon in Japan, and after listening to an emergency call he took in his office while we were there, someone I would want fighting for me on the operating table. The risk factor for recoiling isn’t as extensive as my first coiling because it wouldn’t be because of a ruptured aneurysm and I’d be home from the hospital on the same day. The same risk factor would hold true
for the clipping, although it’s far more invasive and would probably require a long hospital stay.

I’m doing okay. Still processing this information. But I’ve always known I could be at risk, so we’ll just deal with what God deals me, when he deals it. I’m feeling good now, the Dr. didn’t feel it needed immediate attention, so we’ll cross that bridge when we get to it, right?

4-Year Annie Checkup

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I had my 4 year MRA checkup on Monday. This time, due to insurance selection, it was at Mid Coast Hospital in Brunswick. I can say they were very efficient, but not so concerned about patient comfort.

I DID get to listen to some 70’s tunes during the xray, so that was nice, but other than, I can’t say they were overly concerned with if I was cold, comfortable, or having any issues. I was cold, uncomfortable and surprised they didn’t have me remove my bra, seeing how it was an underwire and Maine Med always makes me remove it.

Anyway…I won’t get the results back until possibly Dec. 2nd or 3rd when I meet with Dr. Eckert for the first time. Hopefully, everything checks out.

Smoking and Aneurysms

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This is an interesting article pertaining to aneurysms and smoking.

Smoking, Family History Increase Risk of Stroke

By Rose Hoban, Durham, North Carolina

Every day people are stricken by stroke. There are two kinds of this brain injury: The first occurs when a blood clot blocks blood flow to the brain, denying oxygen to the brain cells. The other kind of stroke occurs when a person has a hemorrhage in the brain or the surrounding structures. Hemorrhagic strokes are devastating. Forty percent of people who experience one will die. Most surviving patients are left with significant disability.

Most hemorrhagic strokes are caused by aneurysms

Daniel Woo, a researcher at the University of Cincinnati, says most of these hemorrhagic strokes are caused by aneurysms. Woo explains an aneurysm is caused by a weakness in the wall of an artery. Under pressure, those aneurysms can expand like balloons, stretching the arterial wall. 

”And if that enlarges badly enough, it can also burst and cause a hemorrhage,” Woo says. 

Now Woo has done research that looks at the relationship between hemorrhagic strokes and smoking. He says researchers have known smoking is a risk factor for aneurysm formation.

“We also know that having a family member who had a history of aneurysm rupture was also a risk factor for aneurysm formation,” Woo says. 

Woo looked at several hundred people who had had ruptured aneurysms and compared them to people who did not have aneurysms. He found that people who smoked had double the risk for aneurysm. His analysis also found that those with a family history of aneurysm also had twice the risk of forming one. But people who had the family history and who smoked were six times more likely to have a hemorrhagic stroke. He says that means hundreds of thousands, if not millions of people are at much greater risk of having a hemorrhagic stroke due to a combination of genes and behavior.

”Twenty percent of the population [in the U.S.] smokes, and 1 percent of the population has an aneurysm in their head that they just don’t know about,” Woo says. “So the rates can be fairly high of people having this, but so we’re still talking about maybe 1 percent of the population, maybe one in 100 people.” 

Woo says it doesn’t sound large, but he maintains it’s still a significant percentage of the population. 

Woo says that studies have indicated that aneurysms form gradually over time. He proposes that something about smoking causes them to form more readily. 

Woo says one message from this research is clear: Quitting smoking almost immediately reduces the risk of rupturing an aneurysm.

His research is published in Neurology, the journal of the American Academy of Neurology.

Follow-Up to Angio

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The week of Thanksgiving, I was FINALLY able to spend a little bit of time with Dr. D’angelo and ask him the questions I’ve had written down for several months.

First off, we looked the the most recent angiogram and he indicated everything looked very good. So I was happy to hear what the other Dr. told me after the procedure was correct.

He also informed me I didn’t have to be check again for two years. So November of 2010, I’ll get a CTA with contrast. Then, if something of interest shows up, they’ll do an angiogram. Angiograms still carry a risk of stroke and other items as it’s a far more invasive procedure than a CTA or an MRI. I’m happy with that at this point.

Dr. D’angelo also said I was at no more of a risk of stroke than before the annie. Again, glad to hear that. I’m in good health, no blood pressure issues, I don’t smoke so those are all good things in regard to developing another annie. However, with my family history, you never know so I’ll happily get checked out every couple of years to keep myself safe.