In the midst of the pandemic, the Tamil Nadu Government Multi Super Speciality Hospital (TNGMSSH) has started to receive patients from Andaman and Nicobar Islands. One of them underwent a complex transorbital neuro-vascular procedure recently.
V. Anand Kumar, nodal officer of TNGMSSH, said patients from Andaman and Nicobar Islands had started to come in December. Till now, four of them were treated at the hospital, while two others persons were treated and referred to speciality departments for managing co-morbidities at Rajiv Gandhi Government General Hospital.
“The six patients from Andaman and Nicobar Islands required treatment in the specialities of interventional radiology, neurosurgery, oncology and neurology. We also had a patient from Jharkhand and a patient from Kerala. All of them were covered under the Pradhan Mantri Jan Arogya Yojana (PMJAY),” he said.
He added: “The coordinator of PMJAY in Andaman approached us. First, they send us the case reports of the patients and this is forwarded to the respective heads of department. Once we approve, the patient is shifted to the hospital. As the hospital is a non COVID-19 facility, they considered it safe for their treatment.”
Recently, a 50-year-old man, a farmer, from Andaman, underwent percutaneous transorbital embolisation of a carotico cavernous fistula (CCF). A cerebral angiogram revealed dural CCF to be draining anteriorly into ophthalmic veins, and hence, the routine transfemoral approach was not chosen, according to doctors.
A.L. Periakaruppan, associate consultant, Interventional Radiology, TNGMSSH, said, “The left eye of the patient was protruding with visual deterioration when he came to us. We diagnosed him with cavernous dural fistula, an abnormal connection between the internal carotid artery and vein. We took the transorbital percutaneous approach -- that is we cannulated percutaneously and passed a tube and wire through the eye, and blocked the abnormal connection using platinum coil and liquid embolic agent.” The issue could have been caused by trivial trauma or could be age-related, he said, adding: “If left untreated, this could lead to vision loss, bleeding in the brain and death.”
R. Vimala, director of the hospital interacted with the patient, who is yet to be discharged.