What is the incidence of brain METs in the United States?
Of All Cancer Patients
20 – 40%
Will Develop a Brain MET1
Annual MET Incidence2
20% Will Become Symptomatic
200,000 Cases Annually
Brain METs are the most common intracranial neoplasm in adults3
What challenges have been encountered with conventional surgical approaches?
- Morbidity – Complications – Edema3-8
- Increased risk of leptomeningeal spread due to ultrasonic aspirators.9,10
- Hemostasis management in MIS approaches.11
- Harvesting tissue in MIS approaches.
How does the MIPS approach with NICO’s integrated systems solution overcome these challenges?
Challenge #1 – Morbidity – Complications – Edema
Solution: Minimally disruptive, navigable access to eloquent areas.
Challenge #2 – Increased risk of leptomeningeal spread due to ultrasonic aspirators.
Solution: Using the NICO Myriad NOVUS the surgeon can choose to employ a pseudo en bloc technique to keep the external capsule intact while debulking the inner section of the MET.
Challenge #3 – Hemostasis management in MIS approaches.
Solution: Room for bimanual microsurgical technique.
Challenge #4 – Harvesting tissue in MIS approaches.
Solution: High yield tissue collection with NICO Myriad NOVUS and Automated Preservation System.
- Myriad NOVUS resects tissue in a mechanical, non-ablative and non-thermal format so the cellular viability of the specimen is still maintained with minimal crushed effect.
- The tissue filter of the Automated Preservation System ensures all tissue is resected through the device in a sterile, closed tissue trap that mitigates tissue degradation by limiting the sample’s exposure to the atmosphere.
Key Publications
Citations
- Bhangoo SS et al. Evidence-Based Guidelines for the Management of Brain Metastases. Neurosurg Clin N Am 2011; 22:97-104 doi:10.1016/j.nec.2010.09.001
- Rahmathulla G et al. The molecular biology of brain metastasis. J Oncol 2012: 723541 http://dx.doi.org/10.1155/2012/723541
- Patel AJ et al. Impact of surgical methodology on the complication rate and functional outcome of patients with a single brain metastasis. Journal of Neurosurgery, May 2015. 122:1132-1143. doi:10.3171/2014.9.JNS13939
- Stark AM et al. Surgical treatment for brain metastases: prognostic factors and survival in 177 patients. Neurosurg Rev. 2005, 28: 115-119. doi:10.1007/s10143-004-0364-3
- Baker CM et al. Simultaneous resection of multiple metastatic brain tumors with multiple keyhole craniotomies. World Neurosrugery. October 2017. 106: 359-367. doi:10.1016/j.wneu.2017.06.118
- Dubey A et al. Complications of posterior cranial fossa surgery–an institutional experience of 500 patients. Surg Neurol. 2009;72:369-375. doi:10.1016/j.surneu.2009.04.001
- Hadanny A et al. Craniectomy Versus Craniotomy for Posterior Fossa Metastases: Complication Profile. World Neurosurg. 2016;89:193-198. doi:10.1016/j.wneu.2016.01.076
- Brell M et al. Factors influencing surgical complications of intraaxial brain tumours. Acta Neurochir (Wien). 2000;142:739-750
- Suki D, et al. Comparative risk of leptomeningeal disease after resection or stereotactic radiosurgery for solid tumor metastasis to the posterior fossa. Journal of Neurosurgery, February 2008 / Vol. 108 / No. 2 doi:10.3171/JNS/2008/108/2/0248
- Ahn JH, et al. Risk for leptomeningeal seeding after resection for brain metastases: Implication of tumor location with mode of resection. Journal of Neurosurgery, May 2012 / Vol. 116 / No. 5 doi:10.3171/2012.1.JNS111560
- Jackson C. et al. Minimally Invasive Biopsies of Deep Seated Brain Lesions Using tubular retractors under exoscopic visualization. Journal of Neurological Surgery. doi:10.1055/s-0037-1602698