NEUROINTERVENTION JULY Dr VISHAL GAIKWAD MBBS MD DM neurology FINR Gold Medalist Consultant Interventional Neurologist
Case 1 Post MT Staged intracranial Stenting ● 58 M with h/o giddiness and imbalances started at 5 pm at home ● Patient went to private hospital and CT was done ● Patient collapsed in CT brain and immediately CPR given and intubated at same centre ● As patient arrived in casualty was on inotrops with BP 80 systolic ● After vitals stabilisation MR done ● MR - Patchy multiple infarcts in Medulla , thalamus , both cerebellum ● MRA - Proximal basilar not visualised ,distal basilar filling through PCOM ● DSA - complete thrombotic occlusion of right VA beyond V2 segment and left VA hypoplastic ● Mechanical Thrombectomy with balloon plasty done ● Patient attained NIHSS 2 on discharge ● Now plan- Right V4 Intracranial Stenting
Case 2 - Tandem Mechanical Thrombectomy ● 50 M p/w acute onset weakness in right UL and LL since 6 hrs ● NIHSS- 20 ● MRI - Left MCA territory superior division infarct ● MRA - left ICA not visualised from origin ● Plan - Mechanical Thrombectomy with sos rescue Stenting ● DSA - Complete thrombotic occlusion of left Cervical ICA distal to origin ● TICI 3 recanalisation achieved ● Left ICA ballon plasty done rescue Stenting avoided
Case 3- Post MT staged carotid Stenting ● Case of post MECHANICAL Thrombectomy with NIHSS 1 on discharge ● DSA - Left cervical ICA severe narrowing ● Plan - Left Carotid Stenting with EPD
Case 4 - Second Carotid Stenting ● 67. M had Left MCA territory infarct before 6 weeks ● DSA - B/L carotid severe narrowing ● Left Carotid Stenting done before 4 weeks ● Plan - Right Carotid Stenting with EPD
● Neuro team @ Care ciigma hospital offering all sorts of Neuro intervention procedure and mainly active towards Acute stroke care including Mechanical Thrombectomy in MJPJAY and AYUSHMANN Bharat ● procedures done till now ● 1. DSA ● 2. Mechanical thrombectomy in acute stroke patients ● 3. Stent / balloon assisted coiling of small / large Aneurysm ● 4. Web coiling of ruptured / unruptured aneurysm ● 5. CCF coiling ● 6. Intracranial/ Basilar stenting ● 7. Complex carotid stenting and so on ..... ● kindly give benefit to your needy patients ..
Thanks