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Dr. Lavine Weighs in on Hot Debate Over Aneurysm Treatment

Neuro news story about MCA aneurysm treatment debateThe most recent issue of Neuro News International features a familiar name on the cover: our own Dr. Sean Lavine, Clinical Co-Director of Neuroendovascular Services.

The Neuro News article discusses Dr. Lavine’s recent presentation at the European Society of Minimally Invasive Neurological Therapy (ESMINT).

The ESMINT presentation was called “MCA Aneurysms: Surgery or Embolisation? Expert Opinion and Literature Evidence.” Dr. Lavine was one of three experts who presented their opinions and evidence.

In his talk, Dr. Lavine argued that surgical clipping is the best option in most cases of MCA aneurysm. He explained that in his experience with MCA aneurysms, clipping “has a better effect on durability…particularly with respect to unruptured aneurysms.” Dr. Lavine went over the limited data available that compares the two treatments for MCA aneurysms.

But, he acknowledged, every case is different. “One issue that is significant and real,” he cautioned, “is whether or not you have a surgeon who is skilled and who has a low complication rate for treating MCA aneurysms.” Dr. Lavine is just such a skilled surgeon, but they may be getting rarer. He noted that he believes “the number of well-trained and well-practiced surgeons that clip aneurysms is decreasing, particularly in the USA.”

The Neuro News article about Dr. Lavine’s talk is called “Surgery versus endovascular treatment for middle cerebral artery aneurysms: Debate rages on.”

Read the full article in Issue 16 of Neuro News.

Non-experts might wonder

what exactly is an aneurysm, no less an MCA one? An aneurysm is a bulging, weak area in the wall of a blood vessel in the brain. Aneurysms can come in different shapes and sizes, and can happen in different places in the brain. An MCA aneurysm is an aneurysm that happens in a vessel called the middle cerebral artery (MCA).

Continued blood pressure on any aneurysm can cause it to rupture, allowing blood to escape into the brain. A ruptured aneurysm is a life-threatening emergency. So treating an aneurysm, whether or not it has ruptured, involves preventing blood from flowing into that weak bulge.

Like other aneurysms, MCA aneurysms can be treated by clipping or coiling. “Clipping” is an open-brain surgical procedure done with tiny instruments and a microscope. “Coiling,” or embolization, is a minimally invasive procedure performed through a tiny catheter inside the blood vessel.

Both approaches have their advantages and drawbacks. The “clipping or coiling” debate is currently one of the hottest topics in the world of aneurysm treatment.

Read more about Dr. Lavine on his bio page here.


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