Jeroen Boogaarts, neurosurgeon at Radboud university medical center, performs surgery on patients with different types of brain hemorrhages. He specializes in the treatment of aneurysms. An aneurysm is a weak spot in an artery. The wall of the blood vessel here is thinner, creating a bulge. This can eventually rupture, resulting in bleeding between the skull and brain, a subarachnoid hemorrhage.
Boogaarts: "In the past, we generally treated aneurysms with open surgery, opening the skull to close off the aneurysm. But over the past decade there has been a shift, to endovascular surgery. In this treatment, the patient receives a catheter through the groin or wrist and an aneurysm is closed that way.' Boogaarts, like three of his colleagues, does both types of procedures, which is not common. It makes him a doctor who can treat a patient with an aneurysm in different ways.
Intervention via groin or wrist
The advantage of endovascular surgery is that it is less stressful for patients, Boogaarts explains. 'Catheterization does not require the skull to be opened.' Treatment via catheterization can be done in two ways. First, using coils that are inserted through the groin into the aneurysm, which collectively seal the aneurysm. A second way through the catheter is with a kind of umbrella tube that is unfolded in the right place, closing off the aneurysm. This way the blood coagulates.
Boogaarts investigates these procedures: "What we don't really know is how sustainable this treatment of new techniques that are performed via catheterizations are. In open surgery, we place a kind of clip on the aneurysm. Then, as a rule, it always stays closed. But with surgery through the groin, we see a small percentage of aneurysms that fill up again over time. These patients must then be treated again. If that happens every three years, so to speak, it is also enormously stressful.
For the newest techniques, it has not been sufficiently established whether this is a good alternative. Therefore, in the coming years Boogaarts is going to chart the results of these techniques in the Netherlands. 'This registration will hopefully serve as the basis for a clinical study in which we can compare which procedure is best for which patient and which aneurysm.'
Delayed damage
The second part of his research focuses on delayed damage that occurs in some patients about a week after surgery. Boogaarts: "It happens that patients come in reasonably well, but after a week or so they deteriorate. We don't really understand how this can happen, and so we have no means of preventing it. That is extremely frustrating.' The suspicion is that the breakdown of blood from the aneurysm releases substances that are harmful to the brain. Boogaarts wants to find out whether medication can counteract these processes.
Boogaarts praises the cooperation with his colleagues both in the Radboudumc, in the departments of neurology and radiology, and outside. 'Especially with Maastricht UMC+, there is a strong collaboration within the Academic Alliance. We want to strengthen this further; it's good that we use each other's expertise.'
Career
Jeroen Boogaarts studied Medicine, at Utrecht University. Since 2001 he has been working at Radboud university medical center, where he specialized in neurosurgery. He also obtained a master's degree in clinical epidemiology at NIHES. He received his PhD in 2016 for research on quality of care for aneurysm (title thesis: Quality of Care for Aneurysmal Subarachnoid hemorrhage; From theoretical considerations to practical implementations). Since 2019, he has been chairman of the Foundation for Quality Promotion of Neurosurgery and chairman of the Dutch Neurovascular Society.
Jeroen Boogaarts has been appointed professor of "Open and endovascular neurosurgery" for five years as of July 1, 2022. On Friday, June 2, at 3:45 p.m., he will give his inaugural address “Stapsgewijs beter”. Preceding the oration that day is the symposium "Treatment challenges & future innovations in neurovascular diseases" with several national and international speakers.