Updated: February 6, 2014 3:06:24 pm
In 2013, more than 70 patients with bleeding in brain were operated with the world class minimally invasive technology available at the department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research (PGIMER).
Bleeding in the brain can be attributed to multiple reasons. One of the reasons being arteries dilates, increases in size and then it rupture. It is called Cerebral Aneurysm.
“When bleeding occurs, about 20 per cent to 30 percent patients cannot make it to the hospital and die on the spot. However, those who reach hospital, were earlier treated with conventionally open brain surgery. In this, the skull is opened and the damaged artery is clipped,” Dr Vivek Gupta, DM, Interventional Neuroradiologist said.
The only problem with the treatment is that it is very difficult and complicated as the brain is opened.
However, in the new technique ‘Endovascular treatment of Brain Aneurysm,’ bleeding is stopped without opening the brain. The technical success rate of this treatment is 90 per cent to 95 per cent. The doctor added, in north India expect Delhi, PGI is the only institute performing the treatment with this new technique.
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In this, the patient sees about 5 ml incision in the groin. The brain is not touched from outside. From the groin areas, special tubes called catheter are taken right up to the brain and we enter the aneurism and deposit the material there and close it from inside. It is called as ‘Coiling’.
“The treatment was started in PGI in 2000, but it was very slow to begin with. Since, last seven-eight years, the percentage has gone down three to four times. In 2006, we treated around 20 patients a year, but now in 2013, we treated around 70 patients,” Dr Vivek Gupta said.
Comparing the two methods, Dr Vivek said, “In the open surgery, the brain is open and is very complicated. The patient is on bed rest for two to three weeks and the recovery is very slow.
“However, in Coiling, if the patient is not clinically sick because of the bleeding, then a patient wakes up immediately after the surgery.
“If a patient comes to me talking, he/she goes back talking, in a matter of three-four hours.”
Open surgery on an average costs around Rs 70,000, where as coiling costs around Rs 3 lakh. The added OT fees is only Rs 1,000.
The doctor said, apart from it, in case the aneurism is large, then coil will not stay there, so in that case we put stunt along with coiling, it is called as “coiling with stunt,” and it costs around Rs 3-4 lakhs.
“The third and the latest refinement is ‘Flow-diverter.’ It diverts the blood flow from the aneurism into the artery. In international market, it is there from last 2-3 years.
In India, apart from me probably only three more doctors perform this procedure,” he added.
The devise costs around Rs 8 lakh, and we have performed flow-diverter on two patients till now.
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