UNC surgeons complete breakthrough aneurysm treatment

Almost two years ago, a pair of UNC surgeons had a revolutionary idea for the treatment of brain aneurysms.

They wanted to go through the nose.

Merging their interests in medical technology and less invasive surgical methods, Dr. Anand Germanwala and Dr. Adam Zanation decided to remove a female patient’s aneurysm through her nose instead of the traditional open-brain surgery.

After a surgery that typically leaves patients bedridden for days, Germanwala and Zanation’s patient was walking the halls within hours.

Neither had seen such a quick recovery.

“By going through the nose, we never touched the brain—that’s the biggest advantage,” Zanation said.

The pair’s innovative surgery will be featured in the March print issue of the journal “Neurosurgery.”

Normally, surgeons have to lift the brain up because aneurysms are located underneath it. This practice is know to put pressure on the patient’s brain, which can result in damage to nerves for both vision nerves and eye movement.

With the new procedure, a 4-millimeter camera held by Zanation serves as Germanwala’s eyes, allowing him to operate on the patient. Germanwala then places a clip onto the aneurysm, which stops the bleeding.

“Say you were blowing up a balloon,” Germanwala said. “If you put a clip on the part where you blow the air into the balloon, no more air can flow. It’s the same thing placing the clip on the neck of the aneurysm.”

The method also reduces the cost for patients; because it is less invasive and requires the patient to spend fewer days in the hospital, the hospital bill is substantially less expensive.

“Endo-nasal surgery is both less expensive and results in less hospital time than open-brain surgery,” Zanation said.

Despite the increased advantages of the nasal technique, it is far from a commonplace procedure.

Germanwala explained that this procedure was a combination of two techniques which require specialization. He said only a handful of doctors in the world have this combination of specialities, which keeps the procedure from becoming a more widespread form of treatment.

“I think it has opened a lot of eyes in the field to see what is possible,” Germanwala said.

Zanation said the breakthrough is indicative of what can be achieved.

“This shows people that the boundaries that were once thought to exist don’t actually exist,” he said.

Delaware resident Katie Kempski founded Wilson Walk, a foundation that raises money for the Brain Aneurysm Foundation, after her mother’s aneurysm burst during her preparation for surgery. With the shorter preparation time that comes with less invasive surgeries, Kempski said her mother’s complications might have been avoided.

“I truly hope that this new procedure is brought on board at all hospitals worldwide,” she said.

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