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Independence woman undergoes innovative aneurysm procedure
June 14, 2019


INDEPENDENCE, MN – A headache may have saved an Independence woman’s life.

“It felt like someone was squeezing a belt around my head,” Nancy Skoog-Edholm said. “My blood pressure was off the charts. My sister took me to Ridgeview. They did a CT scan. They were able to see an aneurysm.”

Meningitis was causing the headache that September day, but the discovery of the aneurysm was direr.

It led to Skoog-Edholm being one of the first people in the country to receive the Woven EndoBridge, or WEB, and the first person to undergo the procedure at Abbott Northwestern Hospital in Minneapolis.

Dr. Yasha Kayan performed the procedure.

He explained that an aneurysm is a weak spot in an artery that can balloon outwards, and it’s more common than most people think.

“Probably 5 percent of the population has a brain aneurysm,” Kayan said. “Most don’t rupture. There are some that are at a higher risk of rupturing.”

Based on that risk, doctors determine the most appropriate treatment.

One is surgical clipping, where a surgeon blocks blood flow to the aneurysm by applying a small metal clip to its base. That method requires the opening of the skull to access the brain and blood vessels.

“Now, we can treat them noninvasively from inside the vessels,” Kayan said.

The traditional treatment for a brain aneurysm is called coiling.

“You go inside the aneurysm and fill it with soft coils to prevent it from rupturing,” Kayan said. “The problem is, if you’re doing this with an aneurysm with a wide neck or at a branch point with two arteries coming off it, the coils can come off, plug up the branch, and cause a stroke.”

That was the concern with Skoog-Edholm’s aneurysm, as it was both wide-necked and at a branch point.

For that reason, Kayan opted to wait for the FDA to approve the WEB device. That occurred in January, and Skoog-Edholm underwent the procedure in February.

In the meantime, Kayan treated a smaller aneurysm that Skoog-Edholm had by utilizing the coil embolization.

Living with an aneurysm was an unnerving experience, partly because of Skoog-Edholm’s family history.

“My grandma, aunt, and cousins all passed away from ruptured aneurysms,” she said. “ . . . It was scary. You get depressed. I’ve always been so active. I felt so weak.”

That was especially hard for the avid horse rider.

“I’m 68,” she said. “I still want to get in a few good years of riding.”

Kayan assured her that everything would be OK.

“I really felt confident he knew what he was doing,” she said. “I trusted him.”

Kayan was confident, too.

“We were part of the trial to get FDA approval,” Kayan said. “Eight cases were done at Abbott as part of the trial back in 2014 and 2015. There were multiple-center nationwide trials that involved 150 patients . . . I had experience with the device with that trial.”

Kayan noted that European surgeons had been using the device for years.

One of the benefits of it is that the surgeon can customize it to the size of the aneurysm.

“It hugs the walls of the aneurysm,” Kayan said. “You can be much more certain it will stay in place. You plug up the aneurysm while keeping the branches open.”

Other benefits of the WEB procedure are that it takes a fraction of the time to complete and recovery time is quicker.

“I recovered from the second faster than the first,” Skoog-Edholm said. “It took a shorter amount of time. It was only 26 minutes. The other was 3.5 hours.”

“With coiling, you have to pass many coils to fill one space,” Kayan said. “This is one-and-done. With coiling, you may have to use additional devices like a stent to keep the coils in the aneurysm. This is much more streamlined.”

The WEB device has changed the game when it comes to treating aneurysms.

“The main message is that this device gives us the ability to expand the toolkit we have to treat aneurysms,” Kayan said. “It enables us to treat aneurysms that were previously much higher risk to treat and allows us to treat them more safely and quickly. There is less risk of stroke and bleeding in the brain, it’s a quicker procedure, and it enables us to treat a broader spectrum of aneurysms from inside the blood vessels.”

The main message for Skoog-Edholm is that she is alive.

“It would have been fatal,” she said. “I’m very, very lucky.”

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