All Over Experience

NEURORADIOLOGY & NEUROINTERVENTIONAL EXPERIENCE:

NEUROINTERVENTIONAL EXPERIENCE AS A CONSULTANT

As a consultant I have been involved in 1000 aneurysm coiling cases of which I have performed more than 700 cases as a primary operator. I have also performed over:

• 60 brain arteriovenous malformations including dural fistulae
• 25 spinal arteriovenous malformations
• 100 meningioma embolisations
• 20 intracranial angioplasty
• 65 nimodipine injections for vasospasm
• 6 venous sinus stenting
• 6 basilar artery thrombolysis with PENUMBRA kit
• 60 intracranial stenting cases for aneurysms.
• 6 basilar artery thrombolysis with PENUMBRA kit



Experienced in arteriovenous malformations embolisations, spinal interventional procedures, intracranial stenting, epistaxis and tumour embolisation and using Onyx and glue. In my practice the use of balloon as a remodelling technique for aneurysmal coiling has increased to nearly 40% of cases and a recent audit has shown no increase in complication as a result of balloon technique.

Performed approximately more than 2000 catheter angiograms for diagnostic purposes only. Enrolled in various trials that include GOSH, Lantern, IMA 950 glioblastoma.

Trained in carotid stenting and have performed over 15 cases as a primary operator.I am experienced in vertebroplasty/kyphoplasty and have done more than 80 cases.

My other commitments included diagnostic neuroradiology work that included CT and MR reporting, myelograms, spine biopsies
Substantial involvement in service development in Leeds

Working with Dr Goddard and colleagues to improve the neurointerventional service

Development of new interventional procedures introduced like use of pipeline flow diverters.I am familiar with advanced neuroimaging including diffusion and perfusion and spectroscopy. I have introduced MR and CT perfusion imaging for neurovascular patients and brain tumours in Preston.

Substantial involvement in service development in Preston including.etting up a joint neurovascular MDT and clinic with the neurosurgeons

Revolutionising the management of vasospasm in patients with subarachnoid haemorrhage in Preston by introducing newer imaging techniques to diagnose vasospasm, re-establishing a transcranial doppler service and performing cerebral angioplasty.

Working closely with stroke network and various other groups in trust to develop stroke services. I run the stroke MDT once a month with the stroke physicians.

Studied the role of CTA and CT perfusion in SAH and mentored it as a PhD project for a student from University of Manchester. Currently another PhD student is working on CT perfusion on brain tumours in Preston

Developed patient information booklet for aneurysm coiling that will help patients and families to cope during and after the illness in Preston.

NEUROINTERVENTIONAL EXPERIENCE IN TRAINING

• Involved in the treatment and management of over 195 interventional cases with 41 cases as a lead operator. This predominantly involved treatment of both acute ruptured and unruptured aneurysms (176 cases). Gained experience in embolisation of arteriovenous malformations, dural fistula treatment, and external carotid intervention such as embolisation in patients with epistaxis, vertebral and carotid dissections, preoperative tumour devascularisation in glomus tumour and meningiomas, intracranial stenting and use of trispan, onyx and glue.
• Performed 30 myelograms and 25 spinal biopsies. I have managed patients with spinal vascular lesions including vascular malformation and tumour embolisation. Visited The Walton Centre in Aintree, on an ad hoc basis during the last 6 months and observed 30 interventional cases, mainly aneurysms and AVM embolisation, which provided tremendous experience to learn neurointervention from Dr. Hans Nahser.

DIAGNOSTIC NEURORADIOLOGY EXPERIENCE

• Trained in Adult Diagnostic Neuroradiology, Paediatric Neuroradiology, ENT and Head and Neck radiology. Developed skills in interpreting CT and MR angiogram; diffusion weighted imaging and Perfusion imaging in brain tumours, stroke and SAH.
• Experience in MR perfusion using both T1 and T2W imaging in tumours being a part of my PhD thesis. I had 2 months of Diagnostic Neuroradiology training with Professor Anne Osborne during her visit at KEM, Hospital. India
• Performed 30 myelograms and 25 spinal biopsies. I have managed patients with spinal vascular lesions including vascular malformation and tumour embolisation. Visited The Walton Centre in Aintree, on an ad hoc basis during the last 6 months and observed 30 interventional cases, mainly aneurysms and AVM embolisation, which provided tremendous experience to learn neurointervention from Dr. Hans Nahser.

VISITING NEURORADIOLOGY FELLOWSHIP IN USA

• A Visiting Fellow at Rush Presbyterian University, St. Luke's Medical Centre, Chicago for two months, training under Dr. Michael Huckman in Neuroradiology. Dec 1998- Jan1999 Followed by one month as Visiting Fellowship in Head and Neck Radiology at University of North Carolina under Mauricio Castillo in Feb 1999.
• This training included interpretation of neuroimaging studies including MR Spectroscopy. Published two papers, one in Radiology and other in e- AJR at the University of North Carolina.