Now, 'paper-clip' implant to treat high blood pressure

 A novel 'paper-clip' implant that can tackle resistant high blood pressure has been developed. 

The implant, called the ROX coupler, can help in treatment-resistant hypertension, or resistant high blood pressure, a condition in which blood pressure remains high despite treatment with anti-hypertensive medications. 

The ROX coupler is a small metal stent made of nitinol which when deployed, acts like a 'paper-clip' joining an artery and a vein together in the groin area. 

This allows blood to flow between the high pressure artery and the low pressure vein. The Coupler is inserted and put in place via key-hole procedure at the groin under local anaesthesia. 

Doctors used the device successfully on a 56-year-old male patient during an operation on September 16. 

"We carried out this procedure on our first patient, a 56 year old male,  which went extremely well," said Professor  Cardiac Electrophysiology.

"After the initial preparation, it took me and my team just over an hour to put the implant in place. Almost immediately the patient's blood pressure went down to more acceptable levels which we anticipate to further improve with time," the Dr. said. 

The Dr. termed results from the pilot study on the ROX coupler as "promising". 

"Results from the pilot study already done on this new technology look promising. There is a very early response with a reduction in blood pressure in resistant hypertensive patients which appears to be maintained in medium term at least," he said. 

"The procedure is remarkable. I know it is still early days but I have already seen a significant reduction in my blood pressure points. I am amazed!" said the male patient.

"Uncontrolled hypertension can lead to many other medical conditions with dire consequences. Patients with resistant hypertension have blood pressure way above normally accepted levels despite multiple medications in combination," Dr. said. 

"New forms of effective treatment are always welcome and that is the reason why we are conducting properly designed trials to assess the efficacy," he said.

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Brain surgery with local anaesthesia gives teen new life

 Ever heard of a brain surgery where the patient has not been put under the effect of general anaesthesia. It may sound ridiculous or frightening, but this is exactly what 18-year-old went through. Medicos refer to the process as 'awake craniotomy' where the patient is given local anaesthesia to reduce post-operative complications. 

The wondrous feat was performed by DrAmitabh Chanda, a neurosurgeon at the Fortis Hospital. The teenager suffered a seizure in July 2011 and was immediately put under a neurophysician's medication. Despite being put on the medication, Moubani continued to get the fits. After a series of clinical tests and a CT scan, the girl was diagnosed with a tumour on the right side of the brain. Later, a functional MRI and other tests revealed that the tumour was exactly on the motor area of the brain. 

With her board examinations just round the corner, it was the end of the world for the resident of Palashi. But Chanda did not lose hope. He decided to perform 'awake craniotomy' on Moubani. He also sought the help of neuronavigation (a set of computer-assisted technologies used by neurosurgeons to navigate within the skull or the vertebral column during surgery) for precision. 

"I realised that if the surgery was done in the conventional manner, she would become paralytic on the right side. Awake craniotomy is done rarely as all patients aren't cooperative enough and the patient's cooperation along with great coordination between the anaesthesia team and surgeons are of utmost importance for such surgeries. Moreover, female patients become emotionally unstable after such surgeries as their head is shaved off, so I ensured that I make a minimum cut," said Chanda.

Though this operation is similar to a conventional craniotomy, the only difference is the patient stays awake throughout the procedure. This method is preferred by doctors to remove lesions involving functionally important regions of the brain like areas responsible for speech and movement. It helps surgeons to test regions of the brain before they are incised or removed and patient's functions continuously throughout the operation which helps to minimize the risks of such operations.

It was finally on February 8 that the girl was operated upon. "I was given local anesthesia and sedated for the surgery so that she could interact with me throughout the procedure," added Chanda. This reduces the chances of post-operative paralysis and other complications.

"I will remain forever grateful to the team of doctors who operated upon me. Before my operation I consulted many doctors who warned me of becoming paralysed on the right side and loss of speech. But I had complete faith in my doctor who has given me a new life," said a happy teenager.