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February 12th, 2009
11:40 AM ET

How long will an aneurysm repair last?

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

Asked by Isabel, Lancaster, California

I had cerebral aneurysm in 2001 and now have two titanium aneurysm clips in my head. How long do these clips last? Do they at some point in time get loose and I will have a hemorrhage again? I've always wondered about this. "

Answer:

 Hi Isabel, I am so glad that it sounds like you are doing well. The type of operation you are describing is one that I have done many times, as recently as this week. As you may know, cerebral or brain vessel aneurysms are sort of like blisters on the wall of the blood vessel. They are little bulges where the blood vessel becomes weak.

The concern is they can start to leak blood slowly into the brain or they can rupture, causing a large amount of bleeding, called a subarachnoid hemorrhage. If that happens, the patient is likely to experience what is known as a thunderclap headache. This is not an ordinary headache. These come on suddenly and are often described as the worst headache of the individual's life. I had one patient describe it as if someone came up and struck him in the head with a baseball bat. A CT scan will reveal the blood in the brain and a lumbar puncture test will show blood in the cerebrospinal fluid, which is the fluid that bathes and nourishes the brain and spinal cord. Unfortunately many patients will suffer permanent neurological deficits or die after a cerebral aneurysm rupture.

 The goal for the operation is to fix that blister, and to reconstruct the weakened vessel so there is no more bleeding. This operation has to be done quickly, because the highest likelihood of the aneurysm bleeding again is in the first few days. And that gets us to your question, Isabel.

The titanium clips you had placed have been studied for many decades. There is a very low likelihood they will come loose or that the aneurysm will come back, if the clips were placed satisfactorily at the time of your operation. Your doctors probably recommended an angiogram to check that around the time of your operation and in follow-up. One large study says the chance of re-bleeding is less than 1 percent. So, you should be in good shape. Do make sure your clips are MRI compatible should you ever need an MRI, but don't worry about setting off airport detectors or other metal detectors.


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    Hi- I had an enurysm of the femoral artery repaired . Last repair was done 8 years ago. I thought they do not reappear. What are the chance of my enurysm to repeat again. what is the reason behind that they repeat.

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    Oh my word I had a subracknoid aneurysm in 2010. I was terrified to fly after the surgery. The airport after I had called to ask about me going threw the detectors said I could have a body search. When I got to the airport. I didn’t want to draw attention to myself. So I worriedly went threw the detectors.. I still laugh when my then husband said my head would get stuck to the detectors and I would make people late for their flights. I didn’t get stuck, I didn’t cause anyone to miss their flights. I did however want to cry when they made me go threw the detector a second time. My bra caused me grief.
    My clamps to this day are in very good shape. I was in a car accident after this last thanksgiving. Because I was having headaches the ER doctor scanned my head to see if there was any damage to the clamp. The result was. That OHSU did a wonderful job. my clamp to this day is in perfect condition.

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.