Aneurysm Clipping and Coiling
What are Aneurysm Clipping and Coiling?
Aneurysm clipping and coiling are procedures to treat a brain aneurysm, a weakened, bulging area in a brain artery wall that risks rupturing, potentially causing a life-threatening subarachnoid hemorrhage (SAH). Clipping involves surgically placing a metal clip at the aneurysm’s base to block blood flow, while coiling uses a catheter to insert platinum coils into the aneurysm, inducing clotting to seal it off. In India, these procedures are performed in neurosurgery departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, offering advanced care at lower costs compared to Western countries. Understanding the procedures, costs, recovery, risks, and frequently asked questions (FAQs) is crucial for informed decision-making.
Why do you need Aneurysm Clipping and Coiling?
These procedures are indicated for:
- Unruptured aneurysms: Often asymptomatic but treated if large (>7 mm), causing symptoms (e.g., headaches, vision issues), or at high rupture risk (e.g., family history, smoking).
- Ruptured aneurysms: Causing SAH, with symptoms like sudden severe headache, nausea, seizures, or loss of consciousness; requires urgent treatment.
- Specific locations: Aneurysms in the anterior or posterior circulation (e.g., anterior communicating artery, middle cerebral artery).
Clipping is more durable long-term but invasive, while coiling is less invasive but may require retreatment. The choice depends on aneurysm size, location, neck geometry, patient age, health, and surgeon expertise.
Why Do Aneurysm Clipping and Coiling Costs Vary in India?
Costs range from ₹1.1 lakh to ₹4.4 lakh for clipping and ₹1.6 lakh to ₹3 lakh for coiling:
- Procedure Type: Clipping (₹1.1–4.4 lakh) varies with craniotomy complexity; coiling (₹1.6–3 lakh) is costlier due to coils.
- Hospital/Location: Higher in metro cities (e.g., Apollo, Mumbai); lower in government hospitals (e.g., AIIMS, ₹50,000–₹1.5 lakh).
- Surgeon’s Expertise: Experienced neurosurgeons charge more.
- Additional Costs: ICU stay, imaging (CTA, MRA), coils/stents, follow-up angiograms (coiling).
- Insurance: Covered for symptomatic/ruptured aneurysms; Ayushman Bharat offers subsidies.
Aneurysm Clipping and Coiling Procedures
- Before Surgery Evaluation:
- Diagnosis:
- Imaging: CT angiography (CTA), magnetic resonance angiography (MRA), or cerebral angiogram (gold standard) to locate and assess the aneurysm.
- Symptoms: Ruptured aneurysms present with sudden headache, neck stiffness, or neurological deficits; unruptured ones may be found incidentally.
- Blood tests ensure fitness for surgery (e.g., coagulation, hemoglobin).
- Stabilization: For ruptured aneurysms, blood pressure control (e.g., labetalol) and seizure prophylaxis (e.g., levetiracetam) are initiated.
- Consent: Risks, including bleeding or stroke, are explained.
- Diagnosis:
- Surgical Techniques:
- Aneurysm Clipping:
- Performed under general anesthesia, lasting 3–5 hours.
- A craniotomy (skull incision, typically 5–10 cm) exposes the brain.
- The brain is gently retracted, and the aneurysm is located using a microscope.
- A titanium clip is placed across the aneurysm’s neck, stopping blood flow into the sac while preserving the parent artery.
- Intraoperative angiography ensures proper clip placement and vessel patency.
- The skull is closed with plates/screws, and the scalp is sutured.
- Endovascular Coiling:
- Performed under general or local anesthesia, lasting 1–3 hours.
- A catheter is inserted via the femoral artery (groin) and guided to the brain using fluoroscopy (X-ray).
- Platinum coils are deployed into the aneurysm, filling it and inducing clotting to block blood flow.
- Additional devices (e.g., stents, flow diverters) may be used for wide-necked aneurysms.
- The catheter is removed, and the groin incision is closed.
- Aneurysm Clipping:
- After Surgery:
- Clipping: ICU monitoring for 1–3 days; hospital stay of 4–7 days (unruptured) or 1–3 weeks (ruptured).
- Coiling: Shorter stay; often discharged in 1–3 days (unruptured) or 1–2 weeks (ruptured).
- Pain management: IV analgesics (e.g., morphine) for 1–2 days, then oral (e.g., ibuprofen).
- Monitoring: For vasospasm (common 3–14 days post-rupture), managed with nimodipine or induced hypertension.
- Anticoagulants (e.g., aspirin) may be prescribed post-coiling to prevent clotting.
Recovery After Aneurysm Clipping and Coiling
- Hospital Stay: Clipping: 4–7 days (unruptured), 1–3 weeks (ruptured); Coiling: 1–3 days (unruptured), 1–2 weeks (ruptured).
- Post-Surgery Care:
- Pain: Clipping causes more discomfort (1–2 weeks); coiling less (3–7 days), managed with analgesics.
- Activity: Clipping: Avoid heavy lifting for 6–8 weeks; coiling: 2–4 weeks.
- Coiling patients may need blood thinners (e.g., aspirin) for weeks/months.
- Follow-up angiograms (coiling) at 6 months, 1 year to check for recurrence.
- Diet: Start with liquids, progress to a normal diet; avoid alcohol/smoking to reduce vasospasm risk.
- Follow-Up:
- Clipping: Check incision at 1–2 weeks; imaging rarely needed unless symptoms recur.
- Coiling: Regular angiograms (6 months, 1–2 years) due to higher recurrence risk (10–20%).
Most resume normal activities in 3–6 weeks (coiling) or 6–12 weeks (clipping). Success rates are high (90–95% for clipping, 80–90% for coiling), but coiling has a higher retreatment rate.
Risks and Complications
- Surgical Risks:
- Clipping: Bleeding (3–5%), infection (1–3%), brain injury (2–5%).
- Coiling: Vessel perforation (1–3%), clot formation (2–5%), coil migration (rare).
- Post-Surgical Complications:
- Clipping: Higher morbidity (e.g., neurological deficits, 5–10%); vasospasm (30% post-rupture).
- Coiling: Higher recurrence (10–20%); rebleeding (1–2%).
- Both: Hydrocephalus (5–10%), seizures (2–5%).
- General Risks: Anesthesia reactions, stroke (2–5%), death (ruptured cases, 40% if untreated).
- Long-Term: Clipping: Cognitive deficits (esp. >50 years); Coiling: Need for retreatment.
Report fever, severe headache, or neurological changes promptly.
Frequently Asked Questions (FAQs)
What causes a brain aneurysm?
Risk factors include genetics, hypertension, smoking, and conditions like polycystic kidney disease.
Can an aneurysm heal without surgery?
No, most require intervention; small, asymptomatic aneurysms (<5 mm) may be monitored.
Is clipping or coiling better?
Clipping is more durable (lower recurrence, 1–5%) but invasive; coiling is less invasive but has a higher retreatment rate (10–20%).
How soon can I resume activities?
Coiling: 3–6 weeks; Clipping: 6–12 weeks.
Are these procedures covered by insurance in India?
Yes, for symptomatic/ruptured aneurysms; confirm with your provider.
Signs of complications?
Severe headache, seizures, weakness, or vision changes.
Can an aneurysm recur after treatment?
Clipping: 1–5% risk; Coiling: 10–20% risk, often requiring retreatment.
Lifestyle changes post-surgery?
Quit smoking, manage blood pressure, avoid heavy lifting, and attend regular follow-ups.
Conclusion
Aneurysm clipping and coiling are effective treatments for brain aneurysms, with clipping offering durability and coiling providing a less invasive option. India’s top hospitals (Apollo, Fortis, AIIMS) deliver affordable, expert care. Understanding the procedures, costs, recovery, risks, and FAQs empowers patients to make informed choices. Consult a neurosurgeon to determine the best approach for your condition.
Looking for Best Hospitals for Aneurysm Clipping and Coiling
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
1,50,000 |
4,50,000 |
Ahmedabad |
1,80,000 |
5,00,000 |
Ajmer |
1,50,000 |
4,50,000 |
Aligarh |
1,50,000 |
4,50,000 |
Allahabad |
1,50,000 |
4,50,000 |
Amritsar |
1,65,000 |
4,75,000 |
Aurangabad |
1,65,000 |
4,75,000 |
Bangalore |
1,80,000 |
5,00,000 |
Bareilly |
1,50,000 |
4,50,000 |
Belgaum |
1,65,000 |
4,75,000 |
Bhopal |
1,65,000 |
4,75,000 |
Bhubaneswar |
1,65,000 |
4,75,000 |
Bikaner |
1,50,000 |
4,50,000 |
Chandigarh |
1,80,000 |
5,00,000 |
Chennai |
1,80,000 |
5,00,000 |
Coimbatore |
1,80,000 |
5,00,000 |
Dehradun |
1,65,000 |
4,75,000 |
Delhi |
1,80,000 |
5,00,000 |
Dhanbad |
1,50,000 |
4,50,000 |
Durgapur |
1,50,000 |
4,50,000 |
Faridabad |
1,80,000 |
5,00,000 |
Ghaziabad |
1,80,000 |
5,00,000 |
Gorakhpur |
1,50,000 |
4,50,000 |
Guntur |
1,65,000 |
4,75,000 |
Gurgaon |
1,80,000 |
5,00,000 |
Guwahati |
1,65,000 |
4,75,000 |
Gwalior |
1,50,000 |
4,50,000 |
Hyderabad |
1,80,000 |
5,00,000 |
Indore |
1,65,000 |
4,75,000 |
Jabalpur |
1,50,000 |
4,50,000 |
Jaipur |
1,80,000 |
5,00,000 |
Jalandhar |
1,65,000 |
4,75,000 |
Jamshedpur |
1,65,000 |
4,75,000 |
Jodhpur |
1,50,000 |
4,50,000 |
Kanpur |
1,50,000 |
4,50,000 |
Kochi |
1,80,000 |
5,00,000 |
Kolkata |
1,80,000 |
5,00,000 |
Kollam |
1,65,000 |
4,75,000 |
Lucknow |
1,65,000 |
4,75,000 |
Ludhiana |
1,80,000 |
5,00,000 |
Madurai |
1,65,000 |
4,75,000 |
Mangalore |
1,65,000 |
4,75,000 |
Meerut |
1,50,000 |
4,50,000 |
Moradabad |
1,50,000 |
4,50,000 |
Mumbai |
1,80,000 |
5,00,000 |
Mysore |
1,80,000 |
5,00,000 |
Nagpur |
1,65,000 |
4,75,000 |
Nashik |
1,65,000 |
4,75,000 |
Navi Mumbai |
1,80,000 |
5,00,000 |
Noida |
1,80,000 |
5,00,000 |
Patna |
1,50,000 |
4,50,000 |
Pune |
1,80,000 |
5,00,000 |
Raipur |
1,65,000 |
4,75,000 |
Rajkot |
1,65,000 |
4,75,000 |
Ranchi |
1,50,000 |
4,50,000 |
Surat |
1,80,000 |
5,00,000 |
Thane |
1,80,000 |
5,00,000 |
Vadodara |
1,65,000 |
4,75,000 |
Varanasi |
1,50,000 |
4,50,000 |
Visakhapatnam |
1,65,000 |
4,75,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.