OU Medicine Neurosurgeon Achieves First

Patricia Procter of Oklahoma City is one of two patients who became Oklahoma’s first recipients of an innovative device developed to prevent rupture of brain aneurysms. The devices were recently placed by OU Medicine neurosurgeon Bradley Bohnstedt, M.D., during the first such procedures performed in the state.

With not one, but three brain aneurysms, Proctor had to avoid any situation that might increase the risk of aneurysm rupture. “I couldn’t lift anything heavier than 10 pounds and any physical exertion was potentially dangerous. Even bending over could increase the pressure to a dangerous level,” she said.

The presence of the aneurysms and the risks they posed effectively blocked Proctor’s path to treatment for other complex health concerns. Bohnstedt chose to use the WEB®, a mesh-like system that stabilizes the vessel and prevents rupture or recurrent rupture.

Bohnstedt explained that aneurysms - weakened areas in the walls of blood vessels - are common, occurring in 2 to 6 percent of the population, often without symptoms or problems. They can occur in various areas of the body and most remain small and undiagnosed.

However, much like stretched and thinned areas on a balloon, this weakened area of an aneurysm becomes increasingly thin, making it vulnerable to rupture. This makes brain aneurysms dangerous and potentially deadly.

“When aneurysms rupture, 10 percent of patients won’t even make it to a hospital,” Bohnstedt said. “Of those who survive, nearly half will die within six months due to a range of complications.”

Inserted by means of a catheter, the pre-shaped WEB device remains in place permanently. The procedure took about two hours and required two very small incisions, one behind each eye. Proctor said she had to remain reclined on her back for several hours following the procedure to minimize pressure in the treated area.

Bohnstedt explained that smoking and hypertension are among the highest risk factors for aneurysm rupture. Genetic or familial links are present in 10 to 20 percent of cases. With a family history of high blood pressure, Proctor began dealing with the condition in her early 30s.

Many aneurysms are detected incidentally, during diagnostic imaging procedures associated with other conditions. Such was the case for Proctor, whose aneurysms were found during a CT scan, performed in connection with chronic sinus infections that had required multiple surgeries.

The central location between Proctor’s eyes and size made this aneurysm (of the three she has) the best option for treatment using the WEB device. The neck of the aneurysm was comparatively large, which can limit the success of traditional treatment approaches.

The WEB is available in many pre-shaped configurations and selection depends in part on what size best suits the specific aneurysm. The structure of the device serves to encourage growth of the blood vessel’s inner lining over the neck of the aneurysm. This effect prevents recurrence and limits the continual blood flow that would increase pressure on vessel walls. Aneurysms cannot dissolve on their own, so the WEB acts as a life-saving safety net.

“I’m very fortunate that it was found,” Proctor said. “Now, I feel just normal. The things I couldn’t do because I couldn’t move freely, the many things I had to have extra help with – maybe they don’t sound like much, but it’s a lot.

“My life has drastically changed. I’m going places and doing things I haven’t been able to do for a long time. I’m so thankful these advanced technologies are available, and for doctors with such amazing skills to use them.”