The 1st Department of Neurosurgery manages and treats the whole spectrum of modern Neurosurgery, including surgical treatment of diseases of the brain, spinal cord, and spine (disc hernias in the cervical, thoracic, and lumbar region, lumbar spinal stenosis, cervical myelopathy, etc.), utilizing all technologically advanced techniques and methods offered at Metropolitan General.
Our surgical practice, using all modern neurosurgery tools available – neurosurgical microscope, neuronavigation systems, intraoperative imaging modalities, and electrophysiological monitoring techniques – achieves, in a minimally invasive way, to manage and treat all surgical brain and spine conditions and disorders. As a result of such practice, patients require a minimum length of stay, demonstrate immediate mobilization and activation right from the very next day, while they resume their full activities and professional obligations in just a few days.
Our Department is highly specialized in Endovascular Neurosurgery. This specialty refers to the treatment of cerebral aneurysms, vascular malformations, and brain tumors, either via pure surgical procedures or in combination with open neurosurgical techniques. Embolization, a prevailing single-worded term for Endovascular Neurosurgery techniques, refers to the ability to reach the brain without performing open surgery as well as to diagnose and treat vascular diseases of the brain applying purely the intra-arterial approach. Thus, using the femoral artery as the gateway and under X-ray guidance via a dedicated X-ray machine, a special microcatheter which is guided by a special microwire (over the wire catheterization) is advanced into the cerebral circulation through the aortic arch and led into the aneurysmal sac. Through this microcatheter, properly selected and pre-shaped detachable platinum microcoils are guided and released into the aneurysmal sac, which they fill and clot, thus isolating the aneurysm from the cerebral circulation and resulting to its treatment and healing. Similarly, in arteriovenous malformations, using an analogous technique, the nucleus (nidus) of the malformation is catheterized and a liquid embolic agent is injected into it. The liquid agent solidifies instantly and blocks abnormal communication between arteries and veins and, consequently, the presence of arteriovenous malformation itself. Over the last decade, the development and evolution of intravascular techniques have been rapid, constantly expands the range of patients and diseases we deal with intravascularly. The availability of new generation detachable platinum microcoils which demonstrate more and more possibilities and flexibility provided they are used properly and by experienced hands, but also the addition to our quiver of stents and flow diverters which are specially designed for intracranial use, expand our indications and enable us to safely and effectively deal with patients and diseases which, until a few years ago, were considered inoperable.
Today, embolization is performed to treat - without open surgery - the vast majority of vascular diseases of the brain and spinal cord (brain aneurysms, vascular malformations). Our experience in over 2,000 embolization procedures enables us to treat such diseases purely intravascularly, either on an emergent or on a scheduled basis, avoiding open surgery and delivering excellent results and very high healing rates. Cerebral aneurysms, following their sudden rupture and concomitant spontaneous cerebral - subarachnoid hemorrhage, are treated immediately through intravascular blockade of the ruptured aneurysm with urgent embolism, but without disturbing the already damaged edematous brain, while, at the same time, we can treat subarachnoid hemorrhage and its complications using either conservative and/or surgical techniques. Similar surgeries can also be performed on a scheduled basis to treat both unruptured brain aneurysms and cerebrovascular malformations. In addition, we use intravascular techniques preoperatively to reduce perfusion of vascular brain tumors (preoperative angiography and embolization), thus making their subsequent surgical removal not only safer but also more effective.
At the 1st Department of Neurosurgery, all procedures involving diagnosis, therapeutic indications and options, preoperative preparation, intravascular and surgical treatment as well as postoperative hospitalization and both short- and long-term follow-up, are performed by the same neurosurgeon. As a result, the neurosurgeon can simultaneously and in parallel deploy all available intravascular and neurosurgical techniques, choosing each time the most appropriate, safe, and effective treatment strategy for each patient individually. Our experience in over 3,500 endovascular and traditional neurosurgeries ensures the right indications for such procedures and guarantees the best outcome, offering patients high healing rates with the least possible in-patient stay and mobility restriction.
Mitsos Aristotelis, Neurosurgeon
Papachristou Konstantinos, Neurosurgeon
Nastoulis Christos, Anesthesiologist
Contact Number: +30 210 6502093
+30 210 6502097