Aneurysm(Endovascular) Coiling in Delhi, India

The brain has a complex network of blood vessels that carry oxygen-rich blood to different areas. In certain cases, some of these vessels may develop weak, bulging sections known as aneurysms, which can rupture and lead to life-threatening complications if not treated promptly. Aneurysm coiling is a minimally invasive procedure used to secure the aneurysm and prevent rupture. During this procedure, a thin catheter is inserted through a blood vessel, usually in the leg, and guided to the site of the aneurysm. Tiny coils are then placed inside to block blood flow, reducing the risk of bleeding. This treatment offers faster recovery and less discomfort compared to open surgery.

The choice of aneurysm coiling technique depends on the aneurysm’s size, shape, and location within the brain. Here are some of the most commonly used techniques.

Standard Coiling 

This technique involves inserting a thin catheter into a blood vessel, typically in the leg, and guiding it to the site of the aneurysm in the brain. Once in position, tiny platinum coils are placed inside the aneurysm to promote clotting, which helps block blood flow and prevent rupture. Standard coiling is most effective for aneurysms with a narrow neck, where the coils can remain securely in place.

Stent-Assisted Coiling

Some aneurysms have a wide opening, which makes it harder for the coils to stay in place. In such cases, a small mesh tube called a stent is placed in the blood vessel to provide support. The stent helps keep the coils in place while allowing normal blood flow. The stent-assisted coiling method may be used for larger or more complex aneurysms.

Balloon-Assisted Coiling

If an aneurysm has an irregular shape or a wide neck, a balloon may be used during the procedure. A small balloon is carefully inflated near the aneurysm to help hold the coils in place. Once the coils are securely positioned, the balloon is deflated and removed.

Flow Diversion

This method uses a special type of stent that changes how blood flows through the artery. By redirecting blood away from the aneurysm, the device may help the body heal and seal the weak spot naturally. Flow diversion is often considered for complex or hard-to-treat aneurysms.

Choosing the right treatment depends on multiple factors, including the aneurysm’s characteristics and the patient’s overall health.

Usually, aneurysm coiling is recommended in the following situations:

• Ruptured aneurysms: If an aneurysm has burst and caused bleeding in the brain (subarachnoid hemorrhage), coiling is often performed as an emergency procedure to prevent further bleeding and reduce the risk of stroke or death.
  
  
• Unruptured aneurysms with high risk of rupture: Certain aneurysms are more likely to rupture based on their size (typically more than 7 mm), shape (irregular or wide-necked), or location (such as the brain’s posterior circulation). In such cases, coiling may be advised even before any symptoms appear.
  
  
• Symptomatic aneurysms: Even if an aneurysm hasn’t ruptured, it may press against nearby nerves or brain structures, causing symptoms such as headaches, vision problems, or nerve weakness. Coiling may be suggested to relieve these symptoms and prevent rupture.
  
  
• Patients at high surgical risk: In some cases, coiling may be chosen over open surgery (clipping) because it is less invasive and better suited for elderly patients or those with other medical conditions.
  
  
• Re-treatment of previously treated aneurysms: If an aneurysm reopens or continues to grow after initial treatment, coiling can be used again to reinforce the sealed area.

Ultimately, the need for aneurysm coiling is determined on a case-by-case basis. At Max Hospital, our multidisciplinary team considers diagnostic test results, the patient’s age and health, and the specific characteristics of the aneurysm before recommending the best course of action.

Before the procedure, patients go through several important steps to make sure they are ready.

Medical Check-Up 

A full health check may be done, including a review of medical history and a physical exam. This helps the healthcare provider understand the patient’s overall health and any possible risks.

Allergy and Medication Review 

Patients should inform their doctor if they have allergies to contrast dye, iodine, latex, or certain medications. It’s also important to mention any medications being taken, including blood thinners and herbal supplements, as some may need to be stopped before the procedure.

Pre-Procedure Counselling

Patients may need to fast for a specific period before the procedure. If they have a history of bleeding problems, they should discuss this with their healthcare team. Blood tests may be done to check how well the blood clots and assess overall health before the procedure.

Undergoing any medical procedure can bring uncertainty, and understanding the process helps ease concerns. Here’s what patients can expect during aneurysm coiling — from preparation and anaesthesia to the careful placement of coils and post-procedure monitoring.

Preparation

• Patients change into a hospital gown and remove jewellery, dentures, and any other items that might interfere with the procedure.
• An IV line is inserted into the hand or arm for medication and fluids.
• A catheter may be placed in the bladder to drain urine.
• Heart rate, blood pressure, and breathing are monitored throughout the procedure.
• The healthcare provider checks and marks the pulses near the groin to monitor blood flow after the procedure.

Anaesthesia Administration

Patients are administered anaesthesia to keep them asleep, comfortable, and pain-free during the procedure. In some cases, local anaesthesia may be used.

Catheter Insertion

A small incision is made in the groin, and a thin tube (catheter) is inserted into a blood vessel. Using X-ray guidance (fluoroscopy), the catheter is carefully moved through the blood vessels until it reaches the aneurysm in the brain.

Coil Placement

• A special contrast dye is injected to help visualise the aneurysm and surrounding blood vessels.
• A smaller catheter is placed inside the main catheter, and tiny soft metal coils are inserted into the aneurysm.
• The coils form a mesh-like structure, which is intended to encourage clotting and help seal off the aneurysm.

Completion

• Additional coils may be added if necessary to completely fill the aneurysm.
• X-ray images confirm that the aneurysm is properly sealed.
• Once finished, the catheter is carefully removed, and the insertion site is cleaned and covered with a dressing.

The entire procedure usually takes between one to three hours, depending on the aneurysm’s size and complexity.

Recovery after aneurysm coiling requires careful monitoring and gradual healing. Several important steps help ensure a safe and smooth recovery.

Monitoring

After the procedure, patients are moved to a recovery room or the intensive care unit (ICU) for close observation. If the coiling was done for a ruptured aneurysm, ICU care is usually needed. For an unruptured aneurysm, patients may return home within a day or two if their condition is stable.

Patients may be required to remain lying flat for 12 to 24 hours after the procedure. During this time, a nurse will check vital signs, monitor the insertion site, and assess circulation in the affected leg. Pain medication may be given if needed.

Hospital Stay

The length of the hospital stay varies based on the patient’s condition and recovery progress. Some can leave within a day, while others, especially those treated for a ruptured aneurysm, may need longer hospital care or rehabilitation before going home.

Activity Restrictions

Patients are generally advised to avoid heavy lifting, intense exercise, or strenuous activities for a period recommended by their doctor. Returning to normal activities will happen gradually, depending on recovery progress.

Follow-Up

Regular check-ups and imaging tests (MRI, MRA, or angiograms) are conducted to monitor whether the aneurysm remains sealed. The first follow-up scan is generally done about one month after the procedure.

Recovery at Home

At home, patients should rest and avoid overexertion. They should contact their doctor if they experience:

• Fever or chills
• Increased pain, redness, swelling, or bleeding at the insertion site
• Numbness, tingling, or unusual sensations in the leg
• Severe headaches, seizures, or loss of consciousness

Recovery times vary based on overall health, the complexity of the procedure, and whether the aneurysm had ruptured before treatment.

Aneurysm coiling is generally safe, but like any medical procedure, it carries some risks. These may include:

• Aneurysm Perforation: The catheter or coil may puncture the aneurysm, causing bleeding in the brain.
• Blood Clots: Clots may form in blood vessels, affecting blood flow and increasing the risk of stroke.
• Rebleeding: In some cases, the treated aneurysm may reopen or bleed again, needing further treatment.
• Infection: Although rare, an infection may develop at the incision site in the groin.
• Groin Hematoma: A small blood collection may form where the catheter was inserted, causing temporary swelling or discomfort.

At Max Hospital, we have a dedicated team of highly experienced neurosurgeons, neuro-intervention specialists, and radiologists who work together to deliver the safest and most effective care. With access to advanced imaging and minimally invasive technologies, we ensure precise diagnosis and timely treatment. Patients and their families can feel confident knowing they are in safe, expert hands.

What is the difference between aneurysm coiling and surgical clipping?

Aneurysm coiling is a minimally invasive procedure where coils are placed inside the aneurysm through a catheter to block blood flow. Surgical clipping, on the other hand, is an open surgery where a clip is placed at the base of the aneurysm to stop blood from entering it.

How do doctors decide between aneurysm coiling and surgical clipping?

Doctors decide based on the aneurysm’s size, location, shape, and the patient’s overall health. Coiling is often preferred for aneurysms that are difficult to access with surgery or for patients at higher surgical risk.

Is aneurysm coiling a permanent solution or is there a possibility of it being repeated?

In most cases, coiling offers a long-term solution, but some aneurysms may require follow-up procedures if new growth or coil compaction occurs.

Can lifestyle changes help prevent future aneurysms after coiling?

Yes, quitting smoking, controlling blood pressure, eating a healthy diet, and reducing stress can help lower the risk of future aneurysms.

How long does it take to fully recover from aneurysm coiling?

Most patients recover within 1–2 weeks, though full healing and return to normal activity may take a month or more, depending on individual health.

Will I need to take blood thinners or other medications after the procedure?

Some patients may need antiplatelet or blood-thinning medications to prevent clot formation; your doctor will guide you based on your specific case.

Can I travel by air after aneurysm coiling?

Most patients can travel by air after 4–6 weeks, but it’s essential to consult your doctor before planning travel.

How does age affect the success rate of aneurysm coiling?

Age can influence risks and recovery, but aneurysm coiling is generally safe and effective even in elderly patients when carefully evaluated.

Is aneurysm coiling safe for elderly patients?

Yes, with proper assessment and care, coiling can be safely performed in elderly individuals.

Can aneurysm coiling be done in emergency situations?

Yes, coiling can be performed as an emergency procedure if an aneurysm has ruptured.

How often will I need imaging tests after aneurysm coiling in the long term?

Typically, follow-up imaging (MRI or angiogram) is recommended at 6 months, 1 year, and then periodically, as advised by your doctor.

Are there any dietary restrictions after the procedure?

No specific restrictions, but a heart-healthy diet is encouraged to manage blood pressure and vascular health.

How soon can I return to work after an aneurysm coiling?

Depending on your recovery and type of work, most people can return within 2–4 weeks.

Will I have any visible scars after aneurysm coiling?

No major scars; only a small mark near the groin or wrist where the catheter was inserted, which fades over time.

What are the signs that might indicate a complication after going home?

Severe headache, vision changes, weakness, speech difficulties, or swelling at the puncture site require immediate medical attention.

Can aneurysm coiling affect memory or cognitive abilities?

In most cases, cognitive function is not affected. Any changes are more likely due to the aneurysm itself or related complications rather than the coiling.

Is it safe to undergo MRI scans after having coils placed in the brain?

Yes, the coils used are generally MRI-compatible, but you should always inform the radiologist about your medical history.

Does having a coiled aneurysm increase the risk of future strokes?

The procedure aims to reduce stroke risk from aneurysm rupture. Other stroke risks depend on overall vascular health.

How successful is aneurysm coiling compared to other treatments?

Coiling has shown high success rates with fewer complications and faster recovery compared to open surgical clipping, particularly for certain types of aneurysms.

How does smoking or alcohol consumption affect the success of aneurysm coiling recovery?

Smoking and excessive alcohol consumption can hinder healing and increase the risk of future aneurysms or vascular issues. It’s best to avoid both.

Reviewed by Dr. Kapil Jain, Associate Director – Neurosurgery, Neurosciences, Spine Surgery, Paediatric (Ped) Neurosurgery, on 24 June 2025.