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Unique case of stenting in the Brain |
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On 24th April 2004, the first successful case of ‘Stenting of the Brain’ in India was performed at Jehangir Hospital. |
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For 32 year old Ramdas saikar from Baner, Pune life took an ugly turn when he was 35 years old. He faced 40 attacks of slurring of speech and Paralysis of the right side, all within a span of 7 days. The attacks were frightening and would last 6-10 minutes each. They could have led to permanent disability, loss of speech or even death, according to Dr. Nasli Ichaporia, Consultant Neurologist at Jehangir Hospital. Traditional Medical line of treatment was given for 2-3 days to no avail. At this point of time it was decided to attempt a revolutionary new procedure, which involved putting a stent into the brain. |
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His plight was caused by a severe Stenosis of the Left Middle Cerebral Artery (a major vessel supplying most of the forebrain). It was necessary to open up this narrowing of one of the main blood vessels in the brain, without losing further time, said Dr. Anand Alurkar, Interventional Neurologist attached to Jehangir Hospital. The stent, which measures 2.5 mmx18mm after opening up, remains in the vessel throughout the patient’s life. In this case, Ramdas was relieved of his symptoms immediately after the procedure. |
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This particular procedure is the first of it’s kind in the country, according to Dr. Nasli Ichapora. |
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Ramdas was fortunate to land up at the Jehangir Hospital, which is equipped to carry out this very difficult and risky procedure, he added. |
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Dr. Anand Alurkar, Interventional Neurologist attached to Jeangir Hospital and Dr. karapurkar from Bombay, performed the Stenting. The blockage was confirmed by carrying out a ‘Digital Subtraction Angiography of the Brain’ (DSA), following which a BalloonExpandable Stent was manoeuvred into the blocked blood vessel, using a special technique called ‘Road-mapping’. The stent was passed by thin catheter from the groin into the small vessels of the brain, a procedure that requires great skill and technique. |
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Previously, a balloon would be used to open up the blood vessel, after which the balloon would be removed. |
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This gives relief for about a year, after which the blockage may recur. |
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Steting is technically a far more challenging procedure as compared to Angioplasty. |
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It was the patient’s history of high BP, coupled with his habit of smoking that caused this problem at such a young age, according to Dr. Ichaporia. Unfortunately, nowadays we are seeing many such young patients, with similar case histories . |
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Dr. Ichaporia’s advice to the general public is that any episode of weakness in the limbs. Slurring of speech, temporary loss of vision or fainting must be taken very seriously. This could be a Transient ischemic Attach (TIA) which may culminate in a major Brain Stroke. |
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In fact, the Jehangir Hosptial has set up a spcialised emergency system to deal with such cases. All you need to dial is to dial 1056 for a specially equipped Ambulance with Doctor. It much safer, says Dr. Alurkar, to have our Doctor decide whether this is a harmless episode of weakness or a situation demanding immediate specialised treatment, where every second could be critical. |
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