Thanks to the hybrid surgery facilities, a unique operation on a patient with arteriovenous brain malformation (AVM) was performed in the Almazov National Medical Research Centre.
A 41-year old male patient was transported to the Almazov Centre from the Pskov Region. The vascular rupture in the right occipital lobe led to the brain hemorrhage and large intracerebral hematoma, as a consequence — to the headache, weakness, limbs numbness and immobility. Conservative treatment gave a temporary improvement only. Repeated hemorrhage or increasing intracranial pressure due to hematoma could lead to disability or death.
The pathology localization and its size prevented from using conventional endovascular and microsurgical treatment methods. As a rule, in the Russian clinics, patients with AVM have successional surgeries in different operating rooms without any possibility of intraoperative control at the microsurgical stage.
In this case, the high risk of complications could be avoided only by means of a hybrid surgery allowing various therapeutic approaches within one intervention. Firstly, neurosurgeons of the Almazov Centre performed partial embolization of incorrectly woven thin vessels having isolated them from the blood stream. Then, at the microsurgical stage, the pathological malformation and hematoma were removed. Full intraoperative control showed the result immediately; cerebral angiography and CT angiography were performed during the intervention. Due to this, the specialists were able to make sure that the vascular formation was completely removed and to see that the surgery was successful.
The hybrid operating room allowed avoiding postoperative repeated examinations to assess the quality of the operation performed.
The first stage of the operation was performed by Professor Alexander Savello, the second stage – by Dr. Andrey Sergeev.
The positive dynamics in the patient's condition was noted already on the first postoperative day. After the full recovery, the young man will return to his normal life.