Dr. Martin Lazar has been a pioneer in the development of new technology and
Neurosurgical techniques throughout his career as he addressed the technical
challenges associated with removing tumors in the region of the Vein of Galen
as well as
Skull Base lesions
and
Microvascular techniques.
He was among the first to successfully carry out Extracranial to
Intracranial Carotid Artery (EC-IC) Bypass grafting and helped develop the
instruments used for these procedures.
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Figure 1A (Left): Post-operative Right Carotid Cerebral Angiogram
(Lateral View) Extracranial-Intracranial (EC-IC) Carotid Artery Bypass
Graft. The "NEW" vessel (Arrow) was sewn to the Carotid Artery in the
neck and brought through a Craniotomy opening to the Intracranial
Supraclinoid portion of the Internal Carotid Artery.
Figure 1B (Right): Same Patient (Antero-posterior View) The "NEW" vessel
(Arrow) supplies the Left & Right Anterior Arterial circulation to both
Cerebral Hemispheres.
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He was the first to successfully utilize small vessel arterial bypass
grafting in a young child who suffered a rare congenital vascular (Moya Moya)
disease resulting in Stroke. This 2-year old underwent successful
reconstruction of her cerebral circulation using a 1/2 millimeter scalp artery
that was sewn to one of her intracranial arteries in 1974.
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Figure 2A (Left) & 2B (Right): Operative Photos. A Superficial
Temporal Artery (Broad Arrows) is sutured to a Cortical Branch (Slender
Arrows) of the Middle Cerebral Artery to create an EC-IC Bypass
Graft.
In 2A the anastomosis lacks several more sutures before completion.
There is a small stent in the Cortical Branch to keep it open during
suturing.
In 2B the STA has been opened as has the MCA Cortical Branch.
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Figure 3A (Left): Post-operative External Carotid Artery Angiogram
(Early Arterial Phase). The Superficial Temporal Artery (STA indicated
by the Large Arrow) ordinarily supplies blood to the scalp and is a
branch of the External Carotid Artery. Its suture anastomosis (Slender
Arrow) with a Cortical Branch of the Middle Cerebral Artery (MCA)
demonstrates the difference in diameter between the two vessels.
Figure 3B (Right): Late Arterial Phase (Same Patient) demonstrates the
extent of the arterial blood supply resulting from this "new" vessel.
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Dr. Lazar's special interests lie in the Advanced Microneurosurgical,
Microvascular, Microendoscopic and Minimally Invasive techniques as they apply to
Skull Base,
Pituitary and
Acoustic Tumors,
Orbital Tumors,
Complex Congenital Spinal Disorders,
Spinal Cord Tumors,
Trigeminal and
Glossopharyngeal Neuralgia,
Hemifacial Spasm
as well as more common Spine conditions such as
Herniated Intervertebral Disc and
Spinal Stenosis.
Dr. Lazar is addressing the challenges in applying these highly refined
Minimally Invasive surgical techniques to manage complex tumors of
the Brain and Brain Stem as well as the Spinal Cord. Among his recent advances is
the successful removal of a Calcified Meningioma from the
Anterior Thoracic Spinal Cord region using Minimally Invasive Technique.
(See Figures 4 & 5 below.)
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Figure 4: Operating Room Photo
Dr. Lazar (Left) is assisted by Dr. James E. Bland (Right) while
performing a Minimally Invasive Microsurgical Spine operation.
The surgeons are using a LEICA OH3 Neurosurgical Operating Microscope
that is mounted on an automated stand. Dr. Lazar is able to control
the movement of this microscope using a special "bite-switch" held
between his teeth, thus reducing operating time and fatigue. (Look
for the small "black switch".)
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Figure 4A (Left): MRI Scan of a large Spinal Meningioma compresses
the Spinal Cord (Arrow) within the Spinal Canal.
Figure 4B (Right): Operative Photo of a "Sonopet" ultrasonic Aspirator
being used to remove this Meningioma through a 4 centimeter long
Sofamor-Danek X-tube Retractor.
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Figure 5A (Left): Operative Photo of the Minimally Invasive removal
of the Calcified Intradural Thoracic Meningioma (Arrow). The Spinal
Cord is compressed and displace by the tumor.
Figure 5B (Right): Operative Photo (Same case as Figures 4A&B & 5A).
The Meningioma and its calcified portion have been removed allowing the
Spinal Cord to move toward a more normal position within the Spinal
Canal.
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Figure 6A (Left): Dr. Lazar performing a Minimally Invasive
Microendoscopic Image Guided removal of an Anterior Skull Base tumor.
Figure 6B (Right): Dr. Lazar is performing a Minimally Invasive
Microendoscopic Transsphenoidal removal of a Pituitary Tumor.
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Dr. Martin Lazar
is the author of multiple scientific articles as well as a
developer of Neurosurgical technology and techniques.
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This page last edited on 2/22
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