ENDOVASCULAR NEUROSURGERY: ALL ABOUT IT

WHAT IS ENDOVASCULAR NEUROSURGERY?

Endovascular Neurosurgery is treatment from the inside of the blood vessels. Traditionally a neurosurgeon has had to open up the skull or neck to see the outside of the blood vessels - a modern alternative has been to approach the vessels with tubes (or "catheters") often gaining entry to the blood vessels from the top of the leg.

The treatment is guided by the appearance of X-ray dye injected directly into the blood vessels - to produce an Angiogram.

Endovascular treatment options are appropriate for many different conditions affecting the brain and spine.

WHAT ARE THE CONDITIONS TREATED BY ENDOVASCULAR NEUROSURGERY?

Some of the conditions that are treated by endovascular neurosurgery are:

• Cerebral Aneurysms: Aneurysms are weaknesses in the arteries of the brain. They are somewhat like balloons and are thin walled - with a risk of bursting ('rupturing). There is now evidence that for some aneurysms the safest treatment is with a technique called 'coiling'. This involves passing a tiny tube (catheter) right into the aneurysm and filling the aneurysm with metal or other types of 'coils' - like very tiny pieces of wire wrapped as a spring. Thus, the aneurysm can be filled so that no more blood enters and it seals over.
• Carotid Stenosis: Narrowed arteries going to the brain (carotid or vertebral) can be a source of stroke. Sometimes the safest treatment is to open the artery from the inside. This can involve using a balloon ('angioplasty') or a metal cage called a stent. These techniques can also be applied to blood vessels within the brain (intracranial angioplasty).
• Arteriovenous Malformations: Some of these are best treated with embolization. This is done by injecting either glue or more recently a black material called Onyx into the arteriovenous malformation or AVM to decrease its blood supply. This can be prior to surgery or occasionally instead of surgery.
• Brain Tumours: Some tumours bleed excessively during surgery and benefit from treatment through the blood vessels to block off the blood supply before surgery (embolization).
• Vertebroplasty: Patients who have recently suffered vertebral fractures, especially fractures resulting from osteoporosis, often suffer from back pain of different severity levels. Patients whose back pain does not respond to medication and rest are good candidates for spinal catheterization (vertebroplasty).

This process is performed under sedation and includes the insertion of material deep into the damaged vertebrae bodies. The process usually takes about one to two hours, and almost 90% of patients have significant relief or disappearance of pain thereafter.

WHAT ARE THE BENEFITS OF ENDOVASCULAR NEUROSURGERY?

Endovascular neurosurgery approaches ensure:

• Minimal injury to the normal brain
• Less complications and better outcomes
• Shorter hospital stay
• Treatment of disease, which was not possible in the past
• Angioplasty

WHY KIMS?

At KIMS, one of the best neurosurgery hospitals in Hyderabad, offers exceptional care to patients who require endovascular neurosurgery. Dr. Manas Panigrahi, neurosurgeon in Hyderabad, provides comprehensive brain aneurysm treatment as well as endovascular neurosurgery. We are one of the few centres that offer the latest in brain surgeries.