Dual trained endovascular neurosurgeons. A boon or a necessity?

Abstract

Objective: The aim of this research study is to emphasize the necessity to train neurosurgeons in both endovascular procedures as well as microsurgical clipping in the management of intracranial vascular lesions. Material and methods: In this study, the retrospective data collected from our institution from 2021-2022 is presented. Here we present six cases of intracranial vascular lesions that were initially planned for endovascular procedure and later ended up being managed by microsurgical clipping/ excision. Written informed consent was obtained from relevant individuals for publishing the data. Results: All six patients recovered well in the postoperative period. Therefore, a neurosurgeon who is adequately trained in vascular neurosurgery along with endovascular tutoring shall have an extensive grasp of cerebral vascular diseases and all the available treatment alternatives. Since we live in a result-oriented scenario - patients shall be best served by a hybrid neurosurgeon in the long run. Conclusion: This study provides the intra-operative difficulties faced during endovascular management of intracranial vascular lesions. These difficulties require real-time management. Any delay in the process of intra-procedural decision-making making, the non-availability of trained neurosurgeons can have devastating consequences. Hence, this study further fortifies the want for a dual-trained neurosurgeon to handle cerebrovascular lesions.

Keywords

• cerebrovascular surgery
• clipping vs coiling
• endovascular neurosurgery
• aneurysm
• arteriovenous malformation
• hybrid neurosurgeon