The procedure that the president (PT) will undergo this Thursday (12) is considered an innovative and effective strategy to reduce the risk of new bleeding in cases of patients with chronic subdural hematoma.
The president is hospitalized at Hospital Sírio-Libanês in São Paulo after undergoing emergency surgery following the discovery of intracranial hemorrhage on Tuesday (10). The new procedure was confirmed this Wednesday afternoon (11).
The embolization of the meningeal arteries —which irrigate the meninges, membranes that cover the central nervous system— aims to interrupt the blood flow in a region of the brain.
A study published last month in the scientific journal New England of Medicine shows that the recurrence of bleeding in patients who underwent surgery was 9%, while among those who underwent surgery and then embolization, it was 3%. Previous research has shown even larger differences — from 11% to 3%.
According to neurologists, although the classic treatment received by the president is effective, the fact that he already has additional risk factors, such as age and a busy schedule of air travel, means the chances of bleeding are greater, which justifies embolization.
“In cases where recurrence [do sangramento] It can happen due to risk factors, we opt for embolization. There is sufficient scientific evidence to support this decision”, says Ana Gandolfi, coordinator of the neurosurgical emergency sector at the Escola Paulista de Medicina da Unifesp (Federal University of São Paulo).
According to neurosurgeon Luiz Severo, in general, this procedure is indicated for patients who have undergone surgery and who have had a recurrence of bleeding. “But we are talking about the President of the Republic. So, this set of strategies is justified to avoid a new surgery and all the complications.”
Gandolfi explains that the new procedure is considered low risk and does not increase recovery time
“It’s a bit like a catheterization. But instead of reaching the heart, we do a catheterization to reach the meningeal arteries. It’s an endovascular procedure, you place a catheter inside the artery. It’s less invasive, there’s no court.”
In normal situations, explains the doctor, 24 hours of rest is recommended. “As the president is already hospitalized and the plan is to stay for a week, then not much will change in that sense.”
The neurosurgeon also reinforces that embolization has no relation to bleeding drainage.
“Sometimes, people say: ‘did the surgery go wrong?’ That’s not it. The surgery may have been great, but you do the embolization to try to reduce the chance of recurrence, which we know is relatively high.”
In , the procedure has been offered in research protocols. It is also not offered because it is not included in the ANS (National Supplementary Health Agency) list of procedures.
