What ails the Interventional Radiology Unit of the National Hospital in Colombo, is the question being asked not only by doctors but also patients.
While the Radiology Unit engages in its routine work, groundbreaking Neuro-interventional Radiology, into which it ventured about four years ago, has come to a halt in recent times, the Sunday Times understands.
What these Neuro-illnesses mean:
- A Cerebral ArterioVenous Malformation is an abnormal connection between the arteries and veins in the brain.
- An Aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel.
- The Vein of Galen, which is under the cerebral hemispheres, drains the anterior and central regions of the brain into the sinuses at the back of the head. Aneurysmal Malformation of this vein may result in heart failure or cause developmental delays, hydrocephalus and seizures.
- Carotid-cavernous Sinus Fistula is an abnormal communication between the internal or external carotid arteries and the cavernous sinus.
Neuro-interventional Radiology affords patients the opportunity to undergo this minimally invasive treatment rather than open-brain surgery, it is learnt, while drastically reducing the risk factor as well.
Since 2007, Neuro-interventional Radiology, a technique new to Sri Lanka, saw at least five-six patients per month, who would otherwise have had to submit themselves to open-brain surgery, walking out of the NHSL a few days later.
Such neuro-interventions are utilised to treat cerebral ArterioVenous Malformations (AVMs), Aneurysms and Vein of Galen Malformations which are life-threatening. (See box)
Ambitious plans were also on the cards at the unit to treat victims who have suffered stroke due to blood clots, through this procedure, using stents to retrieve the clots. These Neuro-interventional Radiology procedures helped ease the congestion in the Neuro-Trauma Unit, it is learnt.
“This complex procedure also allowed Interventional Radiologists to venture into areas of the brain which would have suffered injury causing severe repercussions, if subjected to surgery,” a source said, alleging that, since July, this revolutionary treatment had ground to a halt, leaving humble patients in the lurch.
The equipment needed for this less-invasive procedure is available but nothing is happening now, another source said, pointing out that the hospital stays of patients undergoing brain surgery were longer – they have to be kept in the Intensive-Care Unit for several days, moved to the High-Dependency Unit, and only finally to the ward, before being discharged from hospital.
With Neuro-interventional Radiology, patients can leave the hospital quicker, the source added.
The Sunday Times learns that with one of the Interventional Radiologists who was doing these procedures going abroad on leave, no such procedures have been carried out since July. Only “other” procedures such as for carotid-cavernous fistula, which is not only outside the brain but also not life-threatening, are being done at the unit. How many of even those were being carried out was questionable, a source said, asking what were the success rates.
When the Sunday Times contacted a doctor at the Interventional Radiology Unit, he assured that neuro-interventions were still being carried out, but said he didn’t have the figures offhand.
He requested that the Sunday Times call him later, but many attempts to contact him for about two weeks thereafter were futile, as he did not pick up his phone.