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reducing the possibility it may burst or grow further.
Combining the two procedures offered a way to secure the coils, but the trick was that the device was intended for use in the arteries feeding blood into the brain, not those not deep in the brain itself. Coon figured such surgeries had been performed in maybe a handful of cases around the world before he tried it on Atkins.
“Medicine doesn’t do a great job of making devices and treatments for the exceptional, extraordinary cases because they are few and far between. It requires imagination to apply the tools we do have,” Coon said. “This stent was not designed for what we used it for in Brianna, but we were able to think outside of the box.”
The entire procedure was performed through an artery in the groin, threading the coils and the stent up into the brain.
Christopher S. Ogilvy, director of the Brain Aneurysm Institute at Beth Israel Deaconess Medical Center in Boston, said the stent technique is increasingly being used.
“We really need all of these techniques to treat aneurysms and pick the lowest-risk and highest-efficacy treatment for any given aneurysm,” Ogilvy said. “Lots of time in medicine it’s choosing the right tool for the right problem to give you the best results.”
Brain aneurysms are more common in women and often afflict smokers or those with high blood pressure. Some are hereditary.
About 2 million Americans have unruptured aneurysms that they may not be aware of, according to the Aneurysm and AVM Foundation. About 30,000 of them rupture each year, killing about half of the patients and leaving two thirds of the survivors with disabilities.
Of the roughly 350 aneurysm surgeries preformed at Hopkins each year, only about two are done on people under 20, Coon said. He said it’s not clear what caused Atkins’ aneurysm.
Atkins immediately left school when she was diagnosed. Her parents spent the next few weeks staying up at night in shifts to watch her to make sure they could act quickly and call 911 if the aneurysm burst as she slept.
Angel Adams, her mother, called the diagnosis “devastating and scary.” One doctor told her Atkins should be careful not to sneeze to prevent a rupture.
“It’s hard to think that if it ruptures, she’ll be dead,” said Adams, of Apple Valley, Calif. “We didn’t want to think that. We weren’t willing to accept that as her fate. We worked around the clock making phone calls to get what needed to be done so that she would have a chance.”
When Atkins woke up from the surgery, her only complication was that her left leg was immobile. But after about six hours, she regained the use of it.
“The recovery was the most painful part,” she said. “We had to stay in Baltimore for a couple days after, just in case anything happened. I would stay in the hotel room in the dark because nothing helped, it was miserable. Then the headaches got less severe. Now I only get headaches when I get tired.”
Atkins’ teachers sent her schoolwork to do at home while she was recovering and she ended up graduating on time at the top of her class and attending her senior prom.
Atkins is now a full-time student at California State University, Channel Islands, where she is studying liberal arts and education. She hopes to become a kindergarten teacher. She also works full time as a server at a restaurant.
Atkins said her family’s support was crucial to her getting through the health crisis and recovering. She said she feels lucky to have come out of the surgery unscathed.
“It was a really good experience., I got lucky with Dr. Coon,” she said. “I’m really happy with where I am, I’m really grateful.”