Kyle Chapple, MD

New minimally invasive surgery opens door to treatment for previously inoperable brain bleeds

Until a few years ago, anyone suffering from a subdural hematoma – the type of brain bleed most often caused by head injuries – had one surgical option: open brain surgery.

The problem? Not everyone is a candidate for a craniotomy, given limitations on the use of general anesthesia for older patients and those with health complications … not to mention the potential risks of an open procedure.

The alternative? Leave the bleed alone and find a way to manage all of the symptoms, which can include dizziness, confusion, headaches, nausea, seizures and more.

Now, Dr. Kyle Chapple and the team of neurosurgeons at Atlantic NeuroSurgical Specialists (ANS) – one of the largest neurosurgical practices in New Jersey and one of the most advanced in the country – are advocating for a new, minimally invasive technique called endovascular embolization. This approach not only opens the door to treating patients with previously inoperable brain bleeds, but also offers a host of benefits to a wide range of patients with subdural hematomas.

Dr. Chapple recently spoke with NJ Advance Media about this new cutting-edge procedure.

Q:         What is endovascular embolization?

A:          Endovascular embolization is a minimally invasive procedure that essentially enables a neurosurgeon to safely and effectively treat subdural hematomas – a type of brain bleed located between the outside of the brain and the covering of the brain – without open brain surgery. Instead, a catheter is inserted in a large blood vessel at the top of a patient’s leg and navigated up into the blood vessels in the head. Through that catheter, microscopic particles called embospheres are delivered to stop the bleeding. Once that happens, the brain and the body can begin to heal.

Endovascular embolization is a procedure that we have used nearly every day at ANS over the past 20-plus years to treat patients with ruptured brain aneurysms and other conditions. Using the technique for subdural hematomas is very new to the medical community – and also very promising. 

Q:         Who are good candidates for this approach, and how do they benefit?

A:          This procedure changes the game for patients with subdural hematomas. First, it provides a solution for a much wider range of patients than the only other surgical alternative – an open craniotomy, allowing significantly more people who truly need surgical intervention to get it. Second, being a minimally invasive procedure, it carries far fewer risks and potential side effects, and requires much less recovery time. In fact, patients can go home the very next day.

Q:         How effective is the minimally invasive procedure?

A:          As one of the most advanced neurosurgical practices in the country, my colleagues at ANS and I have had extensive early experience with the procedure – all of which supports its safety and efficacy. As the Principal Investigator for this study, I have personally seen fantastic results in our patients who have undergone this procedure over the past few years, and we’re now in the process of generating formal medical research with a randomized study that compares patient outcomes from endovascular embolization versus traditional craniotomies. I’m looking forward to helping drive insight on this innovative approach.

Q:         What should someone do if he or she believes they may be a candidate for endovascular embolization?         

A:         Because the approach is so new and requires highly specialized expertise in endovascular neurosurgery, very few practices currently offer this procedure. To learn more from neurosurgeons who have successfully performed endovascular embolization for subdural hematomas, and how it may help them, they can contact ANS at 973-285-7800.