Pioneering neurosurgeons revolutionized skull base surgery in the 1980s and 1990s. They invented innovative and safer ways to expose the skull base, remove tumours or treat complex aneurysms and vascular lesions and better ways to reconstruct the skull base to minimize cerebrospinal fluid leaks and infection.
The use of endoscopic surgery, improvements in neuroimaging, radiosurgery or high-energy focused radiotherapy, the perfecting of vascular bypass to treat complex neurovascular conditions, and the use of combined skull base approaches have all changed the way complex skull base pathology is treated today.
Dr Florian Roser, Institute Chair, Neurological Institute and neurosurgeon at Cleveland Clinic Abu Dhabi says: “Interventional neuroradiology developed into a minimally invasive treatment for intra-cranial diseases, or disorders of the brain or spinal cord. It was most commonly used for diagnosis of intracranial diseases or problems involving blood vessels in the brain or spinal cord, such as aneurysms, arteriovenous malformations and dural arteriovenous fistulae. Interventional neuroradiology has since evolved to become an innovation focus for treatment of these conditions. Disorders that were untreatable just five years ago can now be addressed thanks to advancements in imaging and implant technologies as well as next level procedural expertise.”
Some of these disorders that are now treatable with neuro-interventional techniques includes embolizing arterio-venous malformations or reconstruction of vessels with in-vessel stents or web-devices for complex intracranial aneurysm.
With Cleveland Clinic Abu Dhabi’s world class services and clinical expertise and technology, its interdisciplinary neuro-interventional services that offer diagnostic and interventional treatments, have seen an influx of complex cases. Conditions which required open brain surgery in the past can now be treated through an interdisciplinary catheter-based intervention that presents lower risks and chances of quicker discharge from hospital, sometimes on the same day.
Dr Roser continues: “Skull base surgeries can be a routine procedure with high success rates. However, every case is unique and presents its own challenges. To ensure our patients receive a higher chance of a successful outcome, we employ advanced technologies and enhanced operational techniques, such as the use of artificial intelligence, to significantly improve and advance patient outcomes for these complex conditions.
“A.I. can improve diagnostic accuracy and therefore reduce neurosurgical errors. It has the potential to improve postoperative care by providing prognostic information, identifying the presence of problems, and tracking relevant data to aid in patient recovery. Cleveland Clinic Abu Dhabi has already introduced the most advanced stroke interventional system in the UAE, the ARTIS Icono. Using 2D and 3D imaging and incorporating A.I., the ARTIS Icono gives the best image quality and reconstruction in real time. This means that surgeons can skip a CT scan and start treatment right away, saving valuable time.”
Cleveland Clinic Abu Dhabi, a Mubadala Health partner, along with Cleveland Clinic, hosted a major global event in March this year, the 2nd International Neuroscience Summit (INS), that aimed to highlight some of the best practices and future trends in the field of interdisciplinary interventional neuroradiology and skull base surgery. The summit discussed some of the most complex conditions mentioned in the field of neurovascular and skull base surgery and identified ways for minimally invasive interdisciplinary treatment for patients dealing with those conditions. It brought together global leading experts in the field to discuss challenges, risks and even complications with the new techniques in order to find consensus in what paths to follow or to avoid, what tools or implants to use and when to indicate treatment from the various options.
