Northland artist benefits from innovative aneurysm treatment

• Arna Rennan

Arna Rennan of Normanna Township, known for her landscape paintings, had a new type of brain aneurysm treatment at the Mayo Clinic in Rochester, Minn., called flow diversion that is far less invasive than other methods. The paintings on the wall are by Rennan. (Bob King / rking@duluthnews.com)

Talk about it

Arna Rennan listened to her worries, and she’s glad she did.

“We tend to be stoic and dismiss worry,” said Rennan, 57. “(But) worry is something to act on. We hear way too many stories of people that dismiss, they tough it out. … But we live in our bodies, and (we) are in tune intimately.”

For Rennan, a local artist with family roots in Norway, her worries led to the discovery of two dangerous aneurysms in her brain. Her desire to destroy the aneurysms led her to the Mayo Clinic in Rochester, Minn., for an innovative procedure that was nonexistent a few years ago.

The alarm sounded on Thanksgiving Day 2010. In retrospect, Rennan said, it probably was a false alarm. But it got her attention.

On that day, she and husband Brian Dack were hosting a family gathering in the rustic log home Dack built at the end of a one-lane road in Normanna Township. It turned out to be a miserable day for Rennan. “All through the night and all through the day I had just the most horrific migraine, and I was vomiting all day,” she said. “And it just wasn’t stopping.”

It was worse than anything she had experienced, Rennan said. And it reminded her of a grim piece of family history. Her mother had died of a ruptured aneurysm at 58, and on the day she died, she had come to the breakfast table with a raging migraine. Rennan has been told that her mother was born with the condition that led to the aneurysm, and that it was hereditary.

Dack took her to urgent care that evening, and Rennan mentioned her family history of aneurysm. Rennan was treated that evening and recovered, but when her physician, Dr. Ingrid Nisswandt-Larsen, read over the report, she recommended an MRI. That revealed not one but two aneurysms in Rennan’s brain. An aneurysm is a widening or a ballooning of an artery due to a weakness in the wall of the blood vessel, according to the U.S. National Library of Medicine. Aneurysms can go undetected and cause no symptoms, but a rupture — also known as a burst — is life-threatening.

“When an aneurysm bursts, quite often the consequences are dire,” said Dr. Guiseppe Lanzino, the Mayo Clinic physician who treated Rennan, in a telephone interview. He said about 2 percent of the adult population has aneurysms, but most never grow and never burst.

Rennan said she learned there was a 15 percent chance one of her aneurysms would rupture, but the odds would increase as she grew older. Nearing the age her mother had been when she died, Rennan didn’t want to take chances. A practicing Buddhist, Rennan took the advice of her “Senior Leaders” to “write the script that you want” regarding treatment. She envisioned a noninvasive procedure, the “absolute best doctor” and a complete cure of her aneurysms.

After researching her options, Rennan turned to Lanzino and what’s known as flow diversion.

The minimally invasive procedure involves placing a wire in a blood vessel via the patient’s thigh. It is fed up to the brain, where it redirects blood away from the aneurysm and back to the vessel. Results aren’t instantaneous, but over time, the blood that’s left in the aneurysm clots and forms a scar. “That scar fills the aneurysm, or sometimes we have seen that the aneurysm retracts,” Lanzino said in the musical accent of his native Italy.

The procedure took place last April. It took about an hour. Rennan went home the next day and experienced nothing more than a little weariness for about a week. A checkup six months later revealed both aneurysms had disappeared. “One other little bugger” has been spotted, Rennan said, but so far isn’t a concern.

“In her case it has been a complete success, because we were able to completely eliminate a very difficult aneurysm which before would have required very complex and dangerous surgery,” Lanzino said.

Last April was also the month when the Food and Drug Administration approved the flow-diversion procedure. During the previous two years, it had been allowed experimentally only at the Mayo Clinic and one other clinic, Lanzino said. Over three years, he has treated more than 60 patients with the procedure.

Flow-diversion won’t make other forms of treatment obsolete, Lanzino said. It couldn’t be used on a ruptured aneurysm, because the treatment takes effect over time, and a ruptured aneurysm requires instant results. It’s currently only recommended for about 20 percent of the aneurysms that haven’t burst, he added.

“These aneurysms are very close (to) or involve the base of the skull,” he said. “In order to expose these aneurysms (surgically), to get there, you do really need to drill a lot of bone. And they are very close to important structures.”

Rennan said she has no regrets about choosing the treatment, and she’s glad for the miserable Thanksgiving that set off the sequence of events.

But her misery that day almost certainly had nothing to do with the aneurysms, she has learned. It probably was prompted by medications she was given following a root canal the day before.

“It was an alarm that connected with my worry,” Rennan said. “In hindsight, I’ll probably know in the future that I have a nasty reaction to certain pain medications. In all likelihood, that’s what it was.”

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