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Endovascular coiling is a minimally invasive procedure used to treat selected intracranial aneurysms from inside the blood vessels. A microcatheter is guided into the aneurysm and used to place soft detachable coils within the aneurysm sac. The coils slow blood flow and promote clot formation inside the aneurysm. The goal is to isolate the aneurysm from normal circulation and reduce the risk of rupture or rebleeding.
read more about endovascular coiling ...Coiling can be used to treat ruptured aneurysms after subarachnoid hemorrhage and selected unruptured aneurysms judged to have a meaningful future rupture risk. The choice between coiling, surgical clipping, flow diversion, observation, or another technique depends on aneurysm size, shape, location, neck width, rupture status, patient age, and overall health. Endovascular treatment is especially useful when open surgery would require difficult access or carry greater operative risk. Some wide-necked aneurysms require balloon assistance, stent assistance, or another adjunctive device.
The procedure is performed under imaging guidance, commonly with general anesthesia. A catheter is introduced through an artery in the groin or wrist and advanced through the arterial system toward the brain. A smaller microcatheter is positioned within the aneurysm, and coils are released sequentially until the aneurysm is adequately packed. Angiography is performed during the procedure to confirm coil position, parent-artery blood flow, and the degree of aneurysm occlusion.
Patients are monitored after coiling for neurological changes, bleeding at the access site, blood pressure abnormalities, and complications of the aneurysm itself. Recovery is often shorter than after open surgical clipping, although patients treated after aneurysm rupture can require prolonged neurocritical care. Follow-up imaging with magnetic resonance angiography, computed tomography angiography, or catheter angiography is commonly used to assess whether the aneurysm remains closed. Some patients require repeat treatment when the aneurysm recanalizes or the coil mass compacts over time.
Possible complications include blood clot formation, ischemic stroke, aneurysm perforation or rupture, bleeding, vessel injury, contrast reaction, and access-site problems. A coil can rarely protrude or migrate into the parent artery and interfere with normal blood flow. Recanalization can occur months or years later, particularly in larger or wide-necked aneurysms, which is why imaging surveillance is important. Stent-assisted procedures add risks related to the implanted stent and usually require antiplatelet therapy.
No. Coiling treats an aneurysm from inside the blood vessels using a catheter, while clipping requires open cranial surgery to place a clip across the aneurysm neck.
No. The coils are intended to remain permanently inside the aneurysm. Tissue and clot form around them as the aneurysm becomes excluded from circulation.
Yes. Recanalization or coil compaction can restore blood flow into part of the aneurysm. Follow-up imaging helps identify aneurysms that need retreatment.
No. The aneurysm is reached through the arterial system using catheters, so a craniotomy is not required for the coiling procedure itself.
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Hemorrhagic Stroke. American Stroke Association. https://www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds. Date Accessed August 12, 2026.
Intracranial Aneurysms: Recurrences More than 10 Years after Endovascular Treatment?A Prospective Cohort Study, Systematic Review, and Meta-Analysis. PubMed. https://pubmed.ncbi.nlm.nih.gov/26057784/. Date Accessed August 12, 2026.
Imaging follow-up strategy after endovascular treatment of intracranial aneurysms: a literature review and guideline recommendations. PubMed. https://pubmed.ncbi.nlm.nih.gov/38523549/. Date Accessed August 12, 2026.