Flow Diverter vs. Surveillance on a 5.4 mm Unraptured Brain Aneurysm

I am not a Dr but I had a similar case, my aneurysm was repaired with a stent. If the neurosurgeon is suggesting a stent then more than likely your aneurysm is treatable through embolization, the stent will be placed using a catheter usually from your groin. The procedure is fairly simple compared to a craniotomy and the recovery is fairly quick. The surgeon will do an angiogram first to map exactly your aneurysm, the angiogram will give him a 3D model of your brain arteries with the location and size of your aneurysm. The angiogram is also done through a catheter, similar to the final surgery. A few months after the surgery he/she more than likely will do another angiogram to monitor the stent and whether the repair is progressing well. He/she could do more angiograms or decide at some point to monitor using MRA/Is.

In my case the first stent did not completely repair my aneurysm so 3 years later I had a second procedure to install a new stent inside the other one. That seemed to do the trick. I got monitored every 6 months after surgery and eventually was moved to every 2 years.

As a reference, my brother also had a brain aneurysm and his bled and needed emergency surgery, they did an embolization but used a coil rather than a stent, the monitoring of his repair was not as thorough as mine and eventually he had a second rupture , that was very critical and they did an emergency craniotomy. That second rupture left him some disability, he is lucky to be alive.

At 5 cm your aneurysm is on the large side, considering embolization is relatively low risk and "simple" and the possible consequences of a rupture, I would consider the repair.

Hope that helps.

@houston13 ,
Thank you for the information. If you don’t mind me asking, what was the size of your aneurysm, how long did you have to stay in the hospital, time frame of recovery and when where you able to go back to work/normal activities?
Sorry, I have a lot of questions.

Thank you in advance.

@srodriguez25: Hi there, again. I see now that you have 2 posts. I responded to the other. I'll answer a few questions here based on my experience. I had my 5.5 aneurysm (it was a clinoid something or other, I'd have to re-read my report) coiled and the procedure was about 3 hours under a general anesthetic. I was kept over night b/c there is a slight risk of stroke up to 24 hours after the procedure (I think I was told 1 in a 1000- so only 1/10th of 1%). I felt perfectly fine after waking up in the recovery bay. I'm retired so I don't know what the recommendation would be for returning to work. Just as an aside, my neurosurgeon told me to always keep blood pressure 130 or lower so I am on blood pressure meds to accomplish that. And Houston13 gave you an excellent review of the embolization procedure.

Hello. Agree with above. Recovery from coiling and stent is individualized. I had mine done on May 10, 2025 for 2 lobulated ICA and P-com unruptured aneurysms. I am noŵ on my 6 months and continue to experience side-effects and complications. I will not write here what these complications are because I don't want anyone scared. But I can share with you the following:
1. Learn about the aneurysm and proposed treatment. Stay on with mayoclinic.org. you tube has many videos about aneurysm.
2. Your recovery period is really dependent upon your overall health and if you have other co morbidities. Know and understand what your neurointerventionist tells you regarding post operative care and recovery. Do not deviate and follow them.
Rest when you are tired, sleep at least 7-8 hours, monitor your BP and stay under 130/90.
Eat a heart and brain healthy meal and hydrate.
There's much more but you can find the rest online.
I wish you the best and pray silenty for your safe procedure and recovery.

@srodriguez25 The procedure is fairly simple and less invasive than more traditional surgeries, the first embolization was early in the morning and I went home late that night, the second one was during COVID and I went home late the next day. If I remember correctly I was back to work a couple of days later. As @maryann mentioned, after the embolization they will keep you horizontally in the recovery room for quite a few hours to ensure the coil or stent stays where it needs to be and to monitor for the chance of a stroke (very small as she mentioned). As any other surgery, recovery depends on your overall health and fitness, but again it is very quick with embolizations in general. My aneurysm was 3mm which was on the smaller side but there is history of ruptured aneurysms in my family (including my brother as I mentioned) so the surgeon recommended I had it fixed as it had vascular access (embolization was possible) and I was in good physical shape which reduces any risk to a minimum. As with all aneurysms, as others have mentioned, controlling your BP is paramount, high BP is the worst enemy of aneurysms so make sure you keep it under control (your PCP or a cardiologist should be able to help you get the right medication regiment). Keep yourself healthy, if you smoke this is a good reason to stop completely, exercise and stay active.

@bebemadrid
Hi, Ms. Lisa. I appreciate your reaction. I am 67, female, Amerasian. Non smoker, no drugs, no co-morbidities. My unruptured ICA and P-com BAs were incidental finðings on May 7, 2025. Coiling and FRED stent was done and was placed on ASA and BRILINTA 90 mg. BID. The Brilinta was what did me in-- bradycardia, dizziness, fatigue for 3 months until I persisted to tell my NI-NS to discontinue it. I have hyper allergies to most drugs, even Plavix. One month after Brilinta was dc'd, my HR stabilized. However, the dizziness continued up until September 30, 2025. I also lost hearing on my left ear. I was in ER 9 times for dizziness, headaches, weakness, kaleidoscope vision. I lost my so called friends. I don't have my siblings here in the U.S. I availed myself with mental health support because I developed intense anxiety and panic attacks. I will have my 6th month MR angiogram in 9 days. I am hoping ang praying so hard that my brain babies are now clotted and healed. I am still taking ASA 81 mg BID. My last CTA, MRI, MRV, and MRA on 8/22/25, showed no recurrent anèurysm, no clots and no brain bleed. I wish I could share openly and freely with those asking for info, but i can only share with them to have faith and hope, that modern medicine, highly experienced NI/NS, our own strength and support, and orgs like Mayo, UCSF Stanford, Cleveland, could get us through with our unanticipated heàlth events. I am grateful to hàve subscribed to Mayo Clinic. Although I tend to choose what to read, some comments offer positivity and distraction from my almost self-induced anxiety. I hope to get better soon! Thank you, Mayo Clinic. May all ŵho seek answers to their queries get the support they need. I pray for recovery for all.