Minimally Invasive Surgery Procedures

Endovascular Surgery

Coiling Surgery for DACA Aneurysm

A 62-year-old female experienced intra-cerebral haemorrhage 6 days back and was unconscious for a day.  She was taken to a nearby doctor and was referred to Lucknow for further management of the issue. At Chandan Hospital, she consulted Dr. Mohammad Iqbal for the same and was diagnosed with DACA (Distal Anterior Cerebral Artery) aneurysm.

Distal Anterior Cerebral Artery Aneurysm (DACA) are rare and comprise about 1.5-9% of all aneurysms in the cerebral circulation. They are usually small in size, distal in location, embedded between cerebral hemispheres and with wide neck.

Dr. Mohammad Iqbal suggested her to undergo endovascular coiling surgery option, which would be free from any major incisions and helps in early recovery. Any surgery makes the patient uncomfortable and brain surgery alone creates a panic situation for both the patient and the attendants.

The patient was operated on successfully and has since then recovered quickly. The below scans show the exact aneurysms in the brain and also the post-operative state of the brain.

Treatment of ACOM Aneurysm

40 year old Sanshodh Rathore was brought to Chandan Hospital after experiencing a stroke like situation 27 days back. He was now experiencing headache, weakness on the right side of the body and disorientation. Dr. Mohammad Iqbal advised initial CT-scans for further diagnosis. On reading the scans, it was made clear that Sanshodh was suffering from ACOM Aneurysm.

The Anterior Communicating Artery (ACOM) Aneurysm is the most complex in all cerebral aneurysms. It is located mostly on the dominant anterior cerebral artery.

He was advised to undergo immediate surgery in order to deal with the aneurysm and prevent any future chances of stroke. Dr. Iqbal performed the surgery within 6 hours of the patient’s visit using the minimally invasive endovascular coiling technique.

Since no massive incisions are made in the patient’s head using this surgery type, he started recovering from the 2nd day of surgery itself. Immediate post operation weakness of the right side of the body increased but later it got better by the 5th day of the surgery. The headaches were also reduced by the 6th day of surgery and the patient was discharged after 12 days with regained body strength.

Comparison between Neurosurgical Clipping and Endovascular Coiling

Neurosurgical clipping provides better results in terms of mortality, re-bleeding, and re-treatments. Endovascular coiling is a better surgical technique in terms of post-operative complications, favourable outcomes, and rehabilitation.

The procedural complications of endovascular coiling are classified as ischemic (spasm during treatment), haemorrhage (aneurysm rupture), and technical (coil in the vessel and aortic dissection).

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