Endovascular Neurosurgery in India
Endovascular neurosurgery, is the field of medicine that combines neurosurgery with interventional neuro- radiology and treats the diseases of blood vessels of the brain and spine. This is a minimally invasive technique which entails using catheters and embolic agents or clotting agents rather than open surgeries.
The procedures are done in angiographic suite (located in the x-ray department), rather than the operating room and is done within the blood vessels using catheters to fill blood vessel abnormalities with particles, polymers or stents.
Endo vascular neuro surgery treats a variety of cerebro vascular diseases which are untreatable through conventional surgery such as:
Advantages of Endovascular Neurosurgery/ Interventional Neuroradiology
The most important advantage of the endovascular approach for the treatment of aneurysms, AVMs and tumors of the brain is one, they can be treated, because sometimes they are considered inoperable or too risky to be operated and thus the patient goes without treatment. Endovascular neurosurgery is the procedure of choice in following patients:
Second, craniotomy or opening of the skull is avoided and thus the procedure is done through minimal invasive technique. This means:
Endovascular surgery in India
India now boasts of the most sophisticated medical technology to treat the most complex cases with great results. The following technology has helped Indian surgeons to have treated the most complex cases:
Use of Bi-plane technology - Visualization in 2 planes simultaneously and 3 D imaging of blood vessels
Advanced Dyna CT capability - Enhances the ability of Endovascular surgeon to perform most accurately in delicate vascular areas like brain
Conditions in which Interventional Neuroradiology/Endovascular Neurosurgery is performed Angioplasty / Stent Placement
Many cases of stroke occur because f the blockage or narrowing of arteries supplying blood to brain. Angioplasty treats stenosis of the arteries in brain or supplying blood to the brain. This includes carotid, vertebral, intra crania arteries thus preventing stroke or treating stroke successfully
An arteriovenous malformation (AVM) is an abnormal collection of blood vessels occurring within the brain itself, which can lead to bleeding, seizures and headache. AVMs can be treated by injecting "glue" or "onyx" through a microcatheter placed precisely into these abnormal blood vessels
Endovascular coiling can treat these aneurysms, thus avoiding open surgery. Studies have shown that coiling treatment leads to better outcomes as compared to open surgical clipping.
Many superficial vascular malformations such as Haemangioma (malformation of the blood vessels) or Lymphangiomas (malformation of lymphs) can be treated by puncturing through a needle, followed by injection of 'Sclerosant Material' whichcauses obliteration of the malformation:
Stroke or Brain attack, including Intra-Arterial Thrombolysis
Acute stroke or brain attack usually occurs due to blockage of arteries of the brain. Appropriate patients can be treated by placing a micro-catheter at the site of blockage followed by administration of thrombolytic drugs, which dissolve the blocking material. Mechanical clot removal can be done in patients even who come many after the stroke
One of the major problems in surgical removal of intracranial tumour is bleeding during the surgery. Interventional Neuroradiologist can help the surgeon by preoperative endovascular occlusion of the blood vessels supplying the tumour. This will reduce the bleeding and facilitate the surgery.
Vertebroplasty and Kyphoplasty
With age, bones become weak and collapse of bones (vertebrae) in the spine is one of the major causes of severe back pain in the elderly. Vertebroplasty is a revolutionary treatment in which "bone cement" is injected through a needle placed into the broken bone so as to stabilize the vertebra and to reduce the pain.