A Neurosurgery team at SRV Hospital, Chembur led by Dr Nilesh Potdar, Dr Nitin Jagdhane and Dr Rakesh Singh successfully performed a complex and complicated aneurysm procedure by using a contouring device giving a new lease of life to a 62-year woman Suman Narayanrao Satpute, who was diagnosed with acute subarachnoid haemorrhage (SAH) where aneurysm from Right middle cerebral artery (MCA )having broad neck was leaking and could have burst open anytime and could have led to patient death.
Satpute is a farmer from a village in Nagpur. She felt down in the morning while doing some household work. For more than 2 hours she was unconscious, and hence in an emergency, she was taken to a hospital nearby, where CT was done to diagnose the cause. There, the doctor revealed that there was a brain aneurysm means ballooning from a blood vessel which having where one blood vessel inside of his brain had burst and the other is on borderline and requires urgent surgery to operate.
Since the hospital in Nagpur was not confident of the patient recovery family decided to take her to Mumbai by cardiac ambulance for further treatment.
Dr Nilesh Potdar, Neurosurgeon at SRV Hospital said, “The patient was diagnosed with acute subarachnoid haemorrhage (SAH) from 3 days. To evaluate her latest brain condition, she underwent Digital subtraction angiography (DSA), a test that provides images of the lumen of the blood vessels including the arteries and veins. 3D CT using 128 slices of an advanced scan of the brain was done to get clear anatomy of the aneurysm. We consulted the family and explain to them the complexity of the patient’s recovery. Looking at the age of the patient, open craniotomy and clipping of aneurysm surgery were ruled out due to the high risk and complexity of aneurysm and it was decided to perform using a contouring device because the wide neck of the aneurysm coiling may be slipped down in the vessel lumen, as it was safe and effective in such treatment of intracranial bifurcation complex aneurysms having a wide neck.”
Explaining the complexity of the procedure Dr Potdar said “Satpute was diagnosed with ruptured aneurysm causing subarachnoid haemorrhage, this is a life-threatening condition. After CT brain angiography and DSA brain angiography, it was confirmed complicated right MCA bifurcation aneurysm had bilobed in nature. Aneurysm had complicated anatomy, very risky for open surgery and clipping of aneurysm which having risk compromise the one branch supplying the brain part causing infarct or risk of bleeding through the aneurysm. This aneurysm was so complex and challenging for the endovascular coiling, because of the wide neck, so chances of coil slippage in the main vessel which causing failure of the procedure and brain infarct.”
“After a thorough evaluation and good quality of 3 D, CT angiography done on 128 slices of machine decided that we can put the endovascular contour device. We successfully placed the Contour device which creates the neck of the aneurysm and seals it in the most physiological manner, after surgery patient is doing well and discharged home in good neurological condition” added Dr Potdar.
Endovascular procedures are stitch less minimally invasive treatment modalities for aneurysm management which reduces the risk of open surgery and prevention of brain injury due to retraction causing reduce hospital stay.