In medical centers worldwide, many life-threatening brain
ailments that used to require risky open-skull operations are being
treated through much less invasive procedures guided by X-ray
technology.
Known as interventional radiology, this newer mode of surgery is
gaining ground in China, and experts in the field look forward to
the day when it will be an affordable alternative for a majority of
eligible patients.
Because of the expense of equipment and imported materials,
Chinese surgeons use the method only in 30 percent of relevant
brain problems, including blood vessel abnormalities, blockages and
swellings, brain tumors and some kinds of strokes, according to a
leading practitioner among China's first generation of
interventional neuroradiologists, Dr. Wu Zhongxue of Beijing's
Tiantan Hospital.
By contrast, Wu said, interventional neuroradiology is applied
in treatment of 90 percent of cases in Europe, 70-80 percent in the
United States and 70 percent in Japan even though his hospital
first adopted the approach as early as 1982, about the same time it
was becoming prevalent in Europe and earlier than in the US.
Tiantan Hospital's Interventional Neuroradiology Department,
which the 56-year-old Wu now heads, has completed more than 900
intracranial aneurysm operations alone, including 200 at the
hospital and 700 at other hospitals nationwide, Wu said. "None of
the other hospitals in the country could possibly have done so
many," he said.
Wu himself, who began working at Tiantan Hospital in 1988 after
completing a doctorate at Capital Medical University, used to do
two of the intricate procedures in a day, and up to 400 operations
in a year. Many of these cases were referred to him by other
hospitals that could not handle them.
Wu said an interventional brain operation may cost from 50,000
to 300,000 yuan (US$6,460-38,780), beyond the means of ordinary
Chinese.
Researchers at his hospital are working on locally-made
substitutes for some of the expensive imports, which is likely to
cut the cost of such operations by half in the future, he said.
The technique involves snaking specially designed catheters,
some no larger than 1.5 mm in diameter, through the blood vessels
of the body to the affected region, guided by X-ray imaging from CT
(computerized tomography) and MRI (magnetic resonance imaging)
machines. "With interventional methods, the incision is small,
recovery fast, and the death rate much lower," said Wu.
International studies also have established that hospitals doing
a greater volume of the procedure have higher success rates, and
Tiantan Hospital has earned a national reputation for its track
record with the treatment.
Nevertheless, given the gravity of their problems, not all
patients survive. Wu noted that some days bring highs and other
lows: "Some patients may recover quickly and leave the hospital
happily in three days, while others may die the next day."
Ironically, while Wu is devoting his career to curing others, he
thinks his own health is suffering as a result. Besides the stress
accompanying his job, he said another repercussion of his daily
work is radiation exposure, which he likens to "chronic
suicide".
Doctors working alongside the X-ray machines wear protective
clothing around the torso, but arms and legs remain unprotected so
that mobility is not affected. "I have suffered all the effects of
radiation, like catching colds easily and lowered levels of white
and red blood cells," he said.
(China Daily April 5, 2007)