Conditions Treated By Dr. Srikanth Boddu

 Pulsatile tinnitus is the whooshing sound that can occur in synch with the heartbeat. That’s often the sound of the flow of blood trying to get past an obstruction. When a scan reveals a narrowing of a blood vessel in the head  (above) as the possible cause, Dr. Boddu can thread a tiny stent up to it and widen it. Dr. Boddu is renowned worldwide for his expertise in this venous sinus stenting procedure.  

 Idiopathic intracranial hypertension (IIH) is sometimes caused by a narrowed blood vessel in the brain, as seen in the 3D angiogram shown above. The increased cranial pressure causes headache, blurred or double vision, and ringing in the ears. Dr. Boddu has been one of the world’s pioneers in a minimally invasive stenting procedure that opens the narrowed vessel and relieves the pressure.  

 A brain aneurysm is a weak spot in a blood vessel wall that bulges out, filling with blood. Imagine blowing up a balloon — if one part of it is thinner or weaker, it starts to bulge out. Most of the time, people don’t even know they have one because it doesn’t always cause symptoms. But if it bursts, it can lead to serious problems, like a stroke or even death, because blood leaks into the brain. When brain aneurysms are large enough, they can cause pressure symptoms or headaches. Dr. Boddu has expertise in the minimally invasive treatment of aneurysms using endovascular techniques that do not require open surgery. 

Above: A brain aneurysm that has been filled with coils to cut off its blood supply.

 An arteriovenous malformation, or AVM, is like a tangle of “short-circuited” blood vessels in the brain or spine. Normally, blood flows through arteries, then into tiny capillaries that slow the blood down, like speed bumps, and finally into veins at the right pressure. But with an AVM, the arteries and veins are directly connected without capillaries in between. It’s like skipping all the speed bumps and going straight from a highway to a narrow street at full speed! This can put too much pressure on the blood vessels, making them more likely to burst and cause bleeding in the brain, which can lead to serious problems like a stroke. Many people don’t even know they have an AVM unless it causes headaches, seizures, or other symptoms — or until it bursts. Dr. Boddu has expertise in treating AVMs using endovascular techniques that do not require open surgery. Above: the tangle of blood vessels of an AVM. 

 Carotid stenosis is a condition in which the large blood vessels in your neck, called carotid arteries, become narrowed or blocked. The carotid arteries are like highways that carry blood to your brain. Over time, fatty deposits can build up on the walls of these arteries, limiting the space for blood to flow — like a highway going from four lanes down to one. When the brain doesn’t get enough oxygen, it can cause serious problems like a stroke

Conventional invasive surgical procedures require general anesthesia and surgical opening in the neck to remove the blockage. In a procedure called angioplasty, endovascular specialists like Dr. Boddu can remove the blockage from the inside of the vessel, reducing the risk of stroke and restoring healthy blood flow to the brain. A small stent is often placed to hold the artery open and allow continued blood flow. With minimally invasive angioplasty and stenting, patients avoid open surgery and general anesthesia. 

  Spinal compression fractures, also called vertebral compression fractures is a small break or crack in one of the bones in your spine (called vertebrae), may be caused by trauma from an accident or a fall. These painful fractures may also occur in those with osteoporosis, a tumor, metastatic cancer, or multiple myeloma. This can cause sudden back pain, make it harder to move around, and even cause you to become shorter if several bones are affected. It’s like when a soda can gets crushed — it doesn’t hold its shape anymore. Interventional neuroradiologists like Dr. Boddu can inject a high-tech filler into the cracks to relieve pain and stabilize the bone. These procedures are called vertebroplasty or kyphoplasty (see below) and are very effective in pain relief and height restoration.

  Cerebrospinal fluid (CSF) flows through the dura surrounding the brain and spinal cord. A CSF leak can cause headaches or other symptoms and can be difficult to diagnose. Dr. Boddu works with the highly specialized CSF Leak team in New York to identify and repair CSF leaks in the brain or spinal column and specializes in treating CSF-venous fistula, a specific type of CSF leak, in a minimally invasive fashion through patient veins.

  A blood clot in the brain is called an embolism, often caused by a small piece of plaque that breaks off from a blocked artery elsewhere in the body. When that clot deprives the brain of oxygen, that’s called an ischemic stroke. With advanced clot retrieval devices that do not require open surgery, Dr. Boddu can restore oxygen to the brain and stop a stroke in its tracks thus preventing / minimizing the permanent brain damage.

  A brain arteriovenous fistula (AVF) is like an accidental shortcut between blood vessels in the brain. In an AVF, the artery abnormally connects directly to a vein, skipping the capillaries. This puts a lot of pressure on the veins, which can cause pulsatile tinnitus, brain swelling, headaches, or more serious problems like bleeding in the brain if the vein weakens and bursts. Dr. Boddu is renowned for the minimally invasive treatment of arteriovenous fistulae using endovascular techniques through arteries and veins that do not require open surgery.  

 As a highly trained and experienced endovascular specialist, Dr. Boddu provides expert care for patients with a wide range of neurovascular conditions. Dr. Boddu treats vascular tumours, arteriovenous fistulae, and other conditions and disorders of the blood vessels of the brain and spine. Above left, blood flow restored; at right the stenosis is visible. Contact Dr. Boddu to arrange a consultation, appointment, or second opinion. 

Venous sinus stenting, or VSS, is an advanced procedure to place a stent in a blood vessel in the brain to relieve the narrowing or stenosis. VSS can relieve the headaches and vision problems of intracranial hypertension as well as the whooshing sounds of pulsatile tinnitus. Dr. Boddu has been a pioneer in venous stenting for well over a decade and has safely performed hundreds of the procedures.  

More about stenting

 Vertebroplasty and kyphoplasty are advanced minimally invasive procedures to repair spinal compression fractures without open surgery. In a vertebroplasty, Dr. Boddu injects a kind of bone cement into the cracks in the affected vertebra. The quick-setting cement restores the height of the vertebra, relieving pain and stabilizing the spine to prevent further damage. Kyphosis, also called balloon vertebroplasty, is a similar procedure that uses a tiny balloon in the fractured bone to restore the height first. The balloon is removed after the bone cement is injected. Photo: a vertebra with a compression fracture, showing the diminished height.

  Some patients experience wear and tear in lower back resulting in inflammation of the vertebrae, causing pain that’s often linked to a small nerve inside the bones called the “basivertebral nerve”. Dr. Boddu uses the Intracept procedure as a treatment for chronic lower back pain, where a special needle to reach the nerve and then applies heat to it, stopping it from sending pain signals to your brain. The Intracept procedure works like turning off a “pain switch.” It’s a minimally invasive procedure, meaning no big cuts or major surgery, and it helps reduce long-term back pain by “silencing” the nerve causing it.

  Preoperative embolization for brain and spine tumours is a procedure done before surgery to make the operation safer, quicker, and easier. Some tumours of the brain or spine may be highly vascular, meaning they have rich blood supplies that help them grow. During surgery, these blood vessels can cause heavy bleeding, making it harder to remove the tumour safely. Embolization is performed before surgery to identify and shut down these feeding blood vessels in a minimally invasive fashion. Dr. Boddu uses a thin tube (catheter) to inject tiny particles or special glue into the blood vessels feeding the tumour. This blocks the blood flow to the tumour, making it shrink and reducing the risk of bleeding during surgery.