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Endovascular Neurosurgery Dr. Nestor R. Gonzalez is refining a procedure called encephalo-duro- arteriosynangiosis (EDAS) surgery to treat patients with progressive narrowing of their brain arteries. EDAS (right) reroutes vessels that feed the scalp through a hole cut in the skull to create new connections between them and the brain tissue. Specialists Use Surgical and Endovascular Techniques Surgeons can now combine conventional surgical techniques with modern endovascular intra-arterial and intra-venous approaches to treat challenging brain lesions. Mechanical retrievers have improved the treatment of stroke by enabling physicians to open arteries from the inside without medications or tools that may potentially increase complications, and have provided an expanded window of time to treat patients. UCLAHEALTH.ORG to Improve Care for Cerebrovascular Patients In the past, cerebrovascular conditions such as stroke and cerebral aneurysms were treated almost exclusively with surgical techniques that required a craniotomy. Today’s latest neurovascular techniques, however, chart smarter, and less risky, pathways to treat problems in hard-to-reach areas of the brain. “We are radically changing the history of how we treat problems of the brain,” says UCLA neurosurgeon Nestor R. Gonzalez, MD, who was one of the first surgeons in the country to receive complex training in neurosurgery and interventional radiology that enables him to perform both neurosurgery and endovascular 1-800-UCLA-888 (1-800-825-2888) neurosurgery. “We now combine conventional surgical techniques with modern endovascular intra-arterial and intra-venous approaches to effectively treat brain lesions that were previously challenging and resulted in less favorable outcomes.” For example, endovascular coiling is a minimally invasive catheter-based procedure that blocks blood f low to a weakened artery wall in the brain (cerebral aneurysm) to prevent the aneurysm from rupturing. According to Dr. Gonzalez, endovascular coiling is now the dominant form of treatment for aneurysms around the world.