Endovascular vs Open Neurosurgery: Which Is Right for You?
By Dashvanth Healthcare Medical Team · Reviewed by our specialists · East Delhi
Two Approaches to Treating Brain Vascular Conditions
Brain aneurysms, arteriovenous malformations (AVMs), and other vascular lesions can often be treated by two different approaches: traditional open surgical craniotomy, or endovascular (catheter-based) techniques. At Dashvanth Healthcare, Dr. Simranjeet Singh is trained in both — ensuring the best technique is chosen for each patient.
Endovascular Neurosurgery
- Access via femoral artery in the groin
- Catheter guided through blood vessels to the brain under X-ray (fluoroscopy)
- Tools delivered through catheter: coils, stents, flow diverters, embolisation agents
- No craniotomy or brain exposure
- Recovery: 1–3 days hospital
Best For:
- Aneurysms: coiling or flow diversion (Pipeline stent)
- AVMs: embolisation (as adjunct to surgery or radiosurgery)
- Arteriovenous fistulae (DAVF)
- Stroke: mechanical thrombectomy (clot retrieval)
- Elderly or high-risk patients
Open Surgical Craniotomy
- Scalp incision and temporary bone flap removal
- Direct visualisation and treatment of the lesion
- Recovery: 3–7 days hospital, 4–6 weeks full recovery
Best For:
- Wide-necked aneurysms unsuitable for coiling
- Large or ruptured AVMs requiring resection
- Associated haematoma needing evacuation
- When endovascular access is technically not feasible
Is endovascular surgery safer than open surgery?
For suitable lesions, endovascular techniques have lower complication rates. The ISAT trial showed coiling is superior to clipping for most ruptured aneurysms. But some lesions are better treated with surgery — your neurosurgeon will explain the specific recommendation for you.
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