Medicosnext
Dr. Saurav Lamichhane
He is a neurointerventionist and the Head of the Department of Interventional Neuroradiology at UDM-NINAS. He specializes in the diagnosis and minimally invasive treatment of cerebrovascular disorders, including stroke, aneurysms, and arteriovenous malformations. His research interests focus on endovascular management of acute ischemic stroke, neurovascular imaging, and innovations in minimally invasive neurointervention. Dr. Lamichhane is committed to advancing the neurointerventional field through clinical research, education, and patient-centered care.
The year 2020 marked a revolutionary chapter in Nepal’s medical history with the installation of the country’s first biplane catheterization laboratory (cath lab) at the UDM-NINAS. This technological milestone was not simply a matter of acquiring advanced equipment; it created hope, pride and emotional resonance throughout the medical community. For a country striving to fulfil the advanced healthcare needs of the underprivileged population, this milestone was both a technical achievement and a deep emotional experience.
This cath lab was not just an installation, it was the realisation of a vision planted years earlier by the late Prof. Dr. Upendra Devkota. Dr. Devkota had dreamed of Nepal where no patient would need to leave the country to access advanced neurological care. Following his passing in 2018, Prof. Dr. Madhu Dixit Devkota carried forth his legacy with unwavering determination resulting in the installation of the biplane cath lab in the institute.
Before 2020, such interventions required referral abroad adding emotional, financial, and logistical burden to patients and families. Bringing this technology to Nepal was not a simple task. The installation of a biplane cath lab required significant capital investment, structural modifications to meet radiation safety, spatial requirement, highly trained professionals, ongoing maintenance and software support.
When the machine was switched on for the first time, the atmosphere in the hospital was electric. It wasn’t just about wires, monitors, and imaging plates; it was about self-reliance, dignity, and progress. For many, witnessing the first successful neuro-interventional procedure using the biplane system (on 11th March 2020) was nothing short of miracle. The event also sparked an interest among young Nepali doctors to specialize in interventional radiology and neurovascular sciences, seeing a future where they could practice world-class medicine without having to emigrate.
A biplane cath lab is a specialized imaging suite equipped with two rotating C-arms that provide real-time, high-resolution, simultaneous imaging from two different projections (frontal and lateral). This technology is essential for precise and minimally invasive neurovascular procedures. Unlike conventional single-plane labs, a biplane system enhances visualization of complex anatomical structures, particularly within the intricate vasculature of the brain. It enables all the complex neurovascular cases like cerebral angiography, aneurysm coiling, mechanical thrombectomy for acute ischemic stroke, embolization of arteriovenous malformations (AVMs), or arteriovenous fistulas (AVFs), angioplasty, stenting, etc.
In the past, when someone was diagnosed with a brain aneurysm or suffered a stroke, the treatment usually meant major surgery. Treatment required opening the skull, physically navigating the delicate brain tissue, and operating directly on the problem. Recovery was long, the risks were high, and the scars were both physical and emotional, that could last for a long time.
Today, many of these conditions can be treated with endovascular procedures with the aid of a biplane cath lab that doesn’t require a single stitch on the head. Endovascular procedures are a form of minimally invasive surgery. Instead of opening the skull, we access the brain or spinal cord through the body’s natural pathways, the blood vessels. Using a pinhole, usually in the groin or wrist, a catheter is navigated through the arteries or veins under real time imaging. We can then deliver treatment directly to the affected area in the brain or spinal cord.
One of the most noticeable benefits to patients is the easier recovery process compared to traditional neurosurgery. As endovascular procedures do not require cutting through the skull or brain tissue, the body experiences far less trauma. For the patient, this means less pain after surgery, minimal scarring, lower risk of infection, shorter hospital stays (sometimes just a night or two). Many patients can return to their daily activities within a week or two, depending on the procedure. Furthermore, endovascular procedures are especially beneficial for patients who are older or who have other medical conditions like high blood pressure, diabetes, heart disease or poor immunity.
Endovascular techniques have become incredibly precise and ensure accessibility to deep or delicate areas of the brain that would be difficult or even impossible to reach safely with traditional open surgery. This shift toward endovascular treatment has not only changed the experience for patients; it has also expanded the horizon of medically possible treatment. Many cases that required complex, risky surgery in the past; can now be treated with a needle puncture, a catheter, and an overnight hospital stay. These days, the first option considered in many cases is no longer a scalpel, but a catheter.
The biggest change brought by endovascular treatment is keeping the patient’s comfort, safety, and quality of life at the center of care. Recovery is faster, risks are lower, and outcomes are often just as good or even better than before. Endovascular procedures represent not just a medical innovation, but a more humane approach to healing, one where patients can walk out of the hospital sooner, with less pain, and a quicker return to the lives they love.
Today, the biplane cath lab at UDM-NINAS is continuing to save lives and giving opportunities to the patients to receive world-class treatment without the physical and emotional burden of major surgery. It stands as a powerful symbol of medical advancement , national aspiration and immortal visionaries of Dr. Devkota.
