Kate Kramer has a passion for hiking mountains. But her toughest challenge wouldn't be on the side of some grand peak. It would be inside her own head.
Kramer's brain aneurysm was discovered, as she says, "by accident." Doctors believe she probably had it for at least 10 years, but it went undetected, like most aneurysms, because it was asymptomatic. In July 2014, she had a brain MRI because of an unrelated condition, and the aneurysm was found. Left untreated, the aneurysm could have ruptured, causing a stroke.
Another surprise for Kramer was that her best treatment option wasn't at UCSF Medical Center or even Cleveland Clinic, but at the Sutter Neuroscience Institute at Sutter Medical Center, Sacramento. Kramer, who lives in the Gold Rush town of Volcano, was one of the first patients to receive corrective surgery through a new minimally invasive, interventional stent called a Low-Profile Visualized Intraluminal Support Device (LVIS) that received approval from the Food and Drug Administration in 2014. Sutter Medical Center was the first hospital in Northern California to use the device.
In the past, Kramer's type of aneurysm could not have been repaired without invasive surgery—taking off a portion of the skull to reach the affected part of the brain. The Low-Profile Visualized Intraluminal Support Device, on the other hand, is a self-expanding stent that is placed in the brain interventionally, meaning it is threaded through the veins to the aneurysm.
Sutter Neuroscience Institute physician Bahram Varjavand, M.D., an interventional radiologist, previously used the stent in trials and was well-trained in placing the new device. The new stent's design allowed Dr. Varjavand to fix Kramer's aneurysm, which had a wide neck and couldn't be repaired using traditional stents. He placed the LVIS stent across the neck of her aneurysm to provide support for the blood vessel affected. Then soft platinum coils were pushed into the aneurysm, bunching together and blocking blood flow into the dilated space. The stent prevents the coils from exiting the aneurysm and maintains the pressure on the coils necessary to keep the aneurysm under control.
After the surgery, Kramer spent two days in the intensive care unit. Less than a month later, she was hiking in New Zealand—something she wouldn't have been able to do if she had undergone traditional brain-aneurysm surgery.
In June 2015, seven months after the surgery, Kramer had a follow-up angiogram that showed everything was doing well—blood was flowing without any problem through the vein, and the stent was holding those coils in place perfectly.
"The LVIS is amazing," Kramer says. "It sits in there and becomes a part of you. Now I don't have to have another angiogram for another five years."
And by that time, she will have climbed many, many more mountains.