Safer technique for stroke, aneurysm patients involves unique path to the brain

Medical Watch

A new but narrow approach to repairing brain abnormalities uses an unlikely route.

This is a new way to save lives after a stroke or if someone has an aneurysm. It’s a route cardiac surgeons take to fix arteries and valves in the heart.

Now neurosurgeons are following behind and picking up improved safety and quicker recovery rates along the way.  

Kristy Tormey has first hand experience.

“It was an incidental finding back in January. I was having a really weird headache I had never experienced before,” she said. “I told my husband something doesn’t seem right.”

Tormey was shocked to learn she needed surgery to fix two aneurysms, one behind each eye.

The 33-year old mother of five was even more surprised when her doctor told her he’d be going in through her wrist to reach her brain.

“I trusted him,” she said. “When I went in and he told me this is what we are going to do. My life was basically in his hands.”

But it was Tormey’s hand where the aneurysm repair began.

The procedure starts by threading a thinly designed catheter into the radial artery then slowly navigating the wire up the arm, making a turn at the shoulder, then another straight up to the brain.

Rush neurosurgeon Dr Stephan Munich said he adopted the technique about two years ago. 

“What we have found is that turn is not as problematic as we initially thought,” he said. “And we’re able to access most blood vessels and perform most procedures thru this approach.”

In Tormey’s case, once the catheter reached each target, Munich deployed a device to redirect blood flow away from the weakened wall of the aneurysm, essentially preventing the vessels from rupturing.

“We can treat everything from strokes to aneurysms to vascular malformations through the transradial approach,” he said.

Munich is performing the majority of his procedures through wrist versus the more traditional route through the femoral artery in the groin.

“The femoral artery is a deeper artery,” he said. “There was a complication rate of accessing that artery of about five to seven percent. When we access the radial artery that complication rate drops to about one to three percent.”

And recovery time is decreased for patients. They just wear a bracelet to apply pressure at the access point to stop postoperative bleeding.

“I was moving around. I was talking. I was eating. I actually wanted to get out of bed and wanted to walk around the hospital floor,” she said. “The recovery is amazing I feel great feel like I never had surgery.”

The approach may not work for every patient — if there’s an unexpected obstacle, doctors switch to the more conventional route through the femoral artery, which requires patients to lay flat for hours after the procedure.

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