Lee Pride, M.D. Answers Questions On: Endovascular Treatments for Cerebral Aneurysms
How have endovascular treatments for cerebral aneurysms changed since you started 20 years ago?
The minimally invasive endovascular techniques I use today got their start in the early 1990s, when physicians at UCLA figured out a way to block aneurysms from inside the blood vessels, using devices called coils.
Over my career, I’ve seen an explosion of technology in different types of coils, different drugs or chemicals that are put on coils, different delivery methods for the coils, and other strategies for treating aneurysms from inside the blood vessels, such as stents.
These methods have significantly matured over the time that I’ve been in practice, and we’ve gotten to the point where what I do is now the primary method of treatment for most aneurysms. And today we’re treating types of aneurysms that I wouldn’t have dreamed possible for us to treat when I started.
How have today’s techniques improved effectiveness and reduced the risk of side effects?
Some of the biggest improvements have been in preventing aneurysm recurrence; historically, aneurysms have a greater chance of coming back after endovascular surgery than after traditional surgery. But there have been many strategies devised to address that.
There are new approaches to the coils and to the catheters we use to deliver the coils; and there are also other devices that we can use in addition to coils, such as stents. In some patients, a stent can be used to direct blood flow away from the aneurysm, which helps reduce the chance of the aneurysm coming back.
How do you decide what approach is the best treatment option for each patient with a cerebral aneurysm?
One reason I feel privileged and proud to be part of the group at UT Southwestern is that we have a very deep bench of specialists on our team.
We have specialists who are involved in taking care of brain aneurysms from every method, and we’ve worked together for a long time. We meet regularly about all the patients we treat. For each patient, we come up with a well-thought-out, multiple-heads-together plan to treat his or her aneurysm, customized to that patient.
So it’s a rewarding environment to practice in because we really do bring all aspects of technology to bear – old and new. Sometimes, older technology works better for a particular aneurysm than the newest thing we have.