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Neurosurgeons Can See The Brain And How It Functions

Armen Hareyan's picture

New technology helps surgeons treat the delicate blood vessels in the brain faster and with less risk.

The new neuroendovascular suite is equipped with the latest in advanced, three-dimensional imaging and interoperative software allowing surgeons to see the blood vessels and surrounding brain tissue in ways they could not before.

Neuroendovascular surgeons use a catheter and an image-guidance system to thread tiny instruments through the femoral artery in the leg up to the brain vessels. The new imaging system at Rush produces 3-dimensional CT scans rendered in real time. As the surgeon snakes the catheter through the twists and turns of the blood vessels, a computerized 3-D image of the blood vessel and surrounding soft tissue can be rotated to view from any angle. The image is translucent allowing the surgeon to see exactly where the catheter is in the tiny blood vessels.

"It can be compared to having a GPS system to guide you to your destination as opposed to navigating by the stars," said Dr. Demetrius Lopes, a neurosurgeon and neuroendovascular specialist at Rush.

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While the procedure it taking place, the surgeon can visualize fine details such as the shape of the aneurysm or the exact placement of a stent. And with the ability to take CT images in the new facility, the impact on other structures in the brain can be immediately evaluated. Potential complications like intracranial bleeding and hydrocephalus can be detected faster than every before. Previously patients often had to be wheeled out of the angiography suite and to the nearest CT scanner an elevator ride away.

In addition to visualizing the brain, it is crucial for surgeons to know how well the brain is functioning during the procedure. In the new suite, Rush anesthesiologists offer a unique neurophysiologic monitoring system.During surgery, the specialists can monitor the patient's vision, sensation and movement even while the patient is under general anesthesia.

"Now we can predict the success of the surgery prior to the patient waking up," said Lopes. "Our main goal is patient safety. With the combination of these systems, we can understand the brain anatomy and the brain function to avoid complications."

In addition to treatment of acute stroke, the new system enhances existing neuroendovascular treatments of cerebrovascular diseases such as aneurysms, stenosis (narrowed arteries), and arteriovenous malformations (AVMs). According to Lopes, the potential of the system it untapped.

"We now have the ability to do what we couldn't in the past. This opens a new window for neuroendovascular surgery," said Lopes. "Complex procedures that once required open surgery can now be offered using a minimally invasive approach."