Equipped with advanced imaging technology and sophisticated medical machinery, the novel minimally invasive endovascular and vascular suite provides the most efficient and safest environment for a patient’s surgical care, according to Dr. Louis Caragine Jr., director of endovascular neurosurgery at Ohio State’s Medical Center.
Radiologists routinely perform endovascular treatments in an angiography suite within a hospital’s radiology department. However, neuroendovascular procedures require examination and therapy by both radiology and neurosurgery staff. If an unforeseen technical complication arises, a patient needs to be immediately transported from the angiography suite to the operating suite for surgical intervention.
“Having the proper, sterile environment allows us to be better prepared if something unexpected occurs. A miniscule delay may result in a poor patient outcome and this new OR will assist us in expediting life-saving treatments,” says Caragine, who is also director of Ohio State’s Neurological Surgery Intensive Care Unit.
The operating suite is designed with biplane digital subtraction angiography, allowing for less radiation scatter than C-arm fluoroscopy. It offers integrated neurosurgical and radiological capabilities resulting in less movement of the patient, as well as a computer control room which monitors the “action.” In addition, the room is capable of three-dimensional angiography, computerized tomography and magnetic resonance imaging guidance.
Repairing of aneurysms, which are weak spots on blood vessels that may bulge, rupture and bleed, will be performed in the new suite. Bleeding can be prevented by either clipping or coiling. Clipping the aneurysm involves a craniotomy, an open, surgical technique used to access the skull and brain.
Under advanced imaging guidance, neurosurgeons can use an easier, less invasive procedure for the patient by threading tiny coils of flexible platinum via a catheter from the groin area to the aneurysm. The coiling technique fills the aneurysm and prevents a rupture from occurring.
The robust operating suite can accommodate open aneurysm operation procedures; arterio-venous malformation repair; brain abnormalities, angioplasty or stent replacement; tumor embolization and presurgical cerebrospinal angiography.
Caragine is one of only about 60 specialists in the country trained to do both open brain surgery and endovascular procedures. He specializes in the treatment of vascular brain diseases, carotid stenosis and stroke using minimally invasive endovascular techniques.