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10 | Health Matters: Providence Saint Joseph Medical Center C hances are, you or someone in your life may benefit one day from neurointerventional surgery. Why? Because the single-incision, image-guided procedure can replace traditional surgery to treat brain, head/neck and spine disorders—as well as stroke and arteriovenous malformations (AVMs). So what does that mean for you or a loved one? According to Adi Iyer, MD, who specializes in neurosurgery and interventional neuroradiology at Providence Saint Joseph Medical Center, patients experience significantly less pain, short (if any) hospital stays and dramatically reduced complications. HOW DOES IT WORK? Neurointerventional surgery is accomplished through a small hole in the skin, usually at the wrist or leg. Through this miniature portal, tiny catheters, needles or tubes are placed and guided within an artery to their intended targets in the brain, head/ neck or spine. Sophisticated biplane imaging uses two rotating cameras, one on each side of the patient, to take simultaneous images to guide into highly sensitive neural structures. The imagery provided to the physicians can be seen on a screen and the doctors can then map the area, such as the brain, and utilize these advanced images to better see and treat the condition. "It's like solving a puzzle," says Dr. Iyer. "The big takeaway is less pain for patients because no incision is necessary." And it may make financial sense as well—even if it requires traveling for the procedure. "Hospital stays are much shorter; usually patients go home the same day. I'm a trained neurosurgeon, so I do both [traditional and interventional surgery] and can do a head-to-head comparison. These procedures rarely have any of the risks that traditional surgery has, which means patients do not typically experience significant blood loss, infections, scarring or brain seizures—or the costs involved with lengthy hospital stays," Dr. Iyer explains. Does this mean traditional surgeries will no longer be necessary in the future? Not at all. In emergency situations, a patient may not have the luxury, or time, to choose an interventional procedure. And it's likely that there won't be a local option: Today only 500 neurointerventional surgeons practice in the United States—making it one of the rarest and most specialized Please visit to find out about upcoming physician lectures for the community. surgical fields. "Therefore, traveling to a hospital that has this technology and trained staff, such as Providence Saint Joseph, ought to be considered," says Dr. Iyer. "I think every patient should be screened for the possibility of having a minimally interventional way to be treated. If there's not a way, they 'll go the traditional route. But oftentimes there is, and I guide them in that direction," he adds. "And certain conditions nearly always benefit from avoiding traditional surgery." For example, a brain aneurysm treated the traditional way requires a portion of the skull to be removed, and the surgery can trigger seizures, blood loss and infections. None of this happens with neurointerventional surgery. "It's quite remarkable how risk—and pain—have been mitigated. It's a huge leap from what we offered just 20 years ago." Neurointerventional Surgery What it is and why you should know about it Dr. Adi Iyer

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