- Associated Press - Monday, November 23, 2015

SPARTA, Wis. (AP) - Charlotte Roehrl is amazed at how good she feels since she became one of the first people in the country to have what she said looked like chicken wire coiled into a blood vessel to repair her brain aneurysm.

“I’m feeling great - it’s amazing,” the 69-year-old Sparta woman said during an interview earlier this month about her mid-September surgery for the bulge in a blood vessel. “Isn’t it unreal?”

Roehrl was speaking of the appearance of the SMART coil that Dr. Mouhammed Kabanni deployed into her groin area, threaded through her body and into her head with a catheter, and curled up like a snake in the aneurysm.

During the appointment where the neuroendovascular surgeon at Gundersen Health System explained the procedure to her, Roehrl said, “He brought in two little boxes. One had a stent, and the other one had what looked like chicken wire.

“‘And don’t drop it,’” she further quoted Kabbani as saying. “‘That’s about $5,000.’”

The high price for the “chicken wire,” which is less than the thickness of a human hair, results from the fact that it is made of platinum - a much more rare and expensive metal than gold.

“I tell people they have jewelry in their head,” Kabbani said with a smile. “I have people with $50,000-plus worth of coil in their heads.”

Roehrl’s path to having platinum inside of her head that matches the hue of her hair on top began during the summer, when she had an odd sensation in her head.

“It wasn’t a pain, but a pressure in the back of my head,” she told the La Crosse Tribune (https://bit.ly/1OTxUlG ). “My mom had a brain tumor, so I get very nervous about things like that.”

Tests showed that she had an aneurysm, “and Dr. Kabbani said I’d had it for a while,” she said. “He explained the options and said since I’d had it for a while, I could choose the surgery or just leave it.”

Mulling the options - the SMART coil or another procedure involving drilling holes in her head - and fearing the possibility that the aneurysm could rupture, she said, “It was weird. I said to myself, ‘This is dumb. Go ahead and get it done and get it over with.’”

The mother of three with her husband, John, Roehrl was hospitalized overnight and recovered in about a week, compared with the more invasive procedure’s recovery period of up to six months, she said.

Kabbani, who has been using the coiling system at Gundersen for about five years, is one of the first surgeons in the country that its manufacturer, Penumbra Inc., selected to use the next generation, the FDA-approved SMART coil.

He has inserted the SMART coil in one other patient besides Roehrl, and the coil has been used only 30 times in the country.

“It is like filling a room to the walls, so that nothing can get in,” Kabbani said.

In aneurysm cases, he uses a catheter inserted into the groin area and uses a fluoroscope to guide him as he maneuvers the coil through the body, then threads it into the aneurysm and coils it repeatedly until it fills the space until it forces the blood to bypass the aneurysm instead of pressuring it, he said.

Other procedures, still used on some patients, involve a craniotomy - drilling into skull and sometimes removing part of it to get to the aneurysm - and tying off the aneurysm or inserting a balloon, he said.

“In general, this is safer” for the patients it is suited for, and about 70 percent of the surgeries these days involve coils, Kabanni said.

The coil also can be used to repair aneurysms that have ruptured, he said.

Brain aneurysms are dangerous, and 25 percent of their victims don’t make it to a hospital, Kabbani said. Out of those who do reach a hospital, 40 percent to 50 percent die within 30 days, he said.

“The new technology allows us to do a better job, faster,” he said. “In the field of coils, we didn’t even know this was possible.”

Roehrl, who is retired from her 25-year job as a manager at Wal-Mart in Sparta, said she did not allow herself to fret about the procedure.

“I was a little bit uneasy, but I tried not to think about it because, when I thought about it, I got nervous,” she said.

Asked whether she feared dying at any point, she said, “I can’t really say I was worried - I had Dr. Kabbani. He is such a sweetheart.”

___

Information from: La Crosse Tribune, https://www.lacrossetribune.com


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