Multidisciplinary Neurovascular Care
Fellowship-trained cerebrovascular surgeons • 12 hospital affiliations across New JerseyMultidisciplinary neurovascular care integrates open neurosurgical and endovascular expertise within a single team to evaluate and treat the full spectrum of cerebrovascular conditions brain aneurysms, arteriovenous malformations (AVMs), cavernous malformations, ischemic stroke, subarachnoid hemorrhage, and carotid artery disease. The combined open/endovascular approach ensures that each patient receives the treatment best suited to their specific anatomy and diagnosis, rather than the treatment available at a single-specialty program.
Key takeaways
- The ABS neurovascular team combines open cerebrovascular surgery and endovascular (catheter-based) expertise, enabling treatment of any vascular lesion with the optimal approach.
- Dr. Ronald P. Benitez is fellowship-trained in both open cerebrovascular surgery and neurointerventional radiology offering true combined expertise in a single surgeon.
- Every complex neurovascular case is discussed at a neurovascular conference to select the safest and most effective treatment strategy.
- 24/7 neurointerventional coverage at Atlantic Health System hospitals enables emergent treatment of ruptured aneurysms and large vessel occlusion stroke at any hour.
- The ABS neurovascular program treats the full spectrum: aneurysm, AVM, cavernoma, stroke, carotid stenosis, dural AV fistula, and vascular tumors.
| Open surgical treatments | Aneurysm clipping, AVM resection, cavernoma resection, bypass surgery, CEA |
| Endovascular treatments | embolization, flow diversion, AVM embolization, thrombectomy, carotid stenting |
| Emergency coverage | 24/7 neurointerventional coverage for ruptured aneurysm and stroke thrombectomy |
| Key surgeon | Dr. Ronald P. Benitez fellowship-trained open cerebrovascular and neurointerventional |
| Conditions treated | Brain aneurysm, AVM, cavernoma, subarachnoid hemorrhage, stroke, carotid stenosis, dural AV fistula |
| Conference review | Complex cases reviewed at neurovascular conference before treatment |
Timing and stay vary by patient and complexity. Your surgeon will confirm what to expect in your case.
Open surgery and endovascular treatment: complementary tools
For most cerebrovascular conditions, both open surgical and endovascular treatment options exist. The best choice depends on the specific anatomy of the lesion, the patient’s overall health, the acuity of presentation, and the evidence base for each approach in that specific context.
Programs that offer only endovascular treatment will recommend endovascular treatment for every patient. Programs that offer only open surgery will recommend open surgery for every patient. A truly multidisciplinary team evaluates each case without that institutional bias recommending whichever approach is genuinely optimal.
Examples of conditions where the choice matters:
- Brain aneurysms: Posterior circulation aneurysms typically favor coiling; wide-necked MCA aneurysms typically favor clipping; some require combined approaches. See coil embolization and surgical clipping.
- AVMs: Small deep AVMs often favor radiosurgery; accessible AVMs with high hemorrhage risk favor surgery; most benefit from pre-surgical embolization. See AVM embolization.
- Stroke: Large vessel occlusion strokes require urgent endovascular thrombectomy; hemorrhagic strokes from ruptured aneurysm require rapid aneurysm securing open or endovascular. See endovascular thrombectomy.
24/7 emergency neurovascular coverage
Cerebrovascular emergencies ruptured aneurysm causing subarachnoid hemorrhage, large vessel occlusion stroke, hemorrhagic stroke require immediate specialist intervention. Delayed treatment is directly associated with worse neurological outcomes and higher mortality.
The ABS neurovascular team provides 24-hour, 7-day neurointerventional and cerebrovascular surgical coverage at Atlantic Health System hospitals. This means:
- Ruptured aneurysms are secured within hours of presentation endovascularly or surgically depending on anatomy
- Stroke thrombectomy is available around the clock with rapid door-to-reperfusion times
- Neurovascular consultation is available for emergency department physicians at any hour for complex presentations
Benefits and risks
Potential benefits
- Unbiased treatment recommendation open or endovascular based on what is best for the individual patient
- 24/7 emergency coverage for ruptured aneurysm and stroke at Atlantic Health System hospitals
- Combined expertise in a single team eliminates the need for multiple specialist referrals
- Access to the full range of endovascular technologies including flow diversion and Woven EndoBridge (WEB) devices
Possible risks
- Individual procedure risks vary by the specific treatment performed see individual procedure pages for details
- Cerebrovascular conditions carry inherent risks from the underlying disease independent of treatment
- Emergency presentations carry higher procedural risk than elective treatment of the same condition
- Complex multimodal treatment plans require close coordination and communication between team members
Your surgeon will review the benefits and risks specific to your diagnosis during your consultation.
What recovery looks like
Recovery varies by the specific neurovascular condition and procedure. See individual procedure pages for detailed recovery timelines:
- Ruptured aneurysm / SAH ICU admission after aneurysm securing; 10 to 21 days monitoring for vasospasm and hydrocephalus.
- Elective aneurysm treatment 1 to 5 nights depending on open vs. endovascular approach.
- Stroke thrombectomy ICU then inpatient rehabilitation; recovery depends on stroke severity and extent of reperfusion.
- AVM treatment Varies by modality embolization is 1 to 2 nights; surgery is 3 to 7 nights; radiosurgery is outpatient.
Frequently asked questions
What is a cerebrovascular surgeon?
A cerebrovascular surgeon is a neurosurgeon with subspecialty fellowship training in the surgical treatment of blood vessel diseases of the brain and spinal cord including aneurysm clipping, AVM resection, carotid endarterectomy, and cerebrovascular bypass. Dr. Benitez has additional fellowship training in neurointerventional radiology, making him proficient in both open and catheter-based neurovascular treatments.
How do I know which treatment is right for my aneurysm?
The choice between coiling and clipping (or other techniques) for your specific aneurysm depends on the aneurysm’s size, shape, neck width, location, relationship to the parent artery, and your overall health. The ABS neurovascular team reviews all these factors and provides a recommendation based on the best available evidence. For complex cases, a second opinion from another high-volume center is always appropriate.
Is a second opinion recommended for brain aneurysms?
For incidentally discovered unruptured aneurysms which are not emergencies seeking a second opinion from an experienced neurovascular center before committing to treatment is entirely appropriate and encouraged. The ABS neurovascular team regularly provides second-opinion consultations for patients referred from other centers.
What is flow diversion and when is it used?
Flow diversion (e.g., Pipeline Embolization Device) is an endovascular technique that places a high-porosity mesh stent across the aneurysm neck in the parent artery. Blood flow is redirected away from the aneurysm, which gradually thromboses over weeks to months. It is used for large or giant aneurysms with wide necks that are difficult to coil or clip, particularly in the internal carotid artery. It is not appropriate for ruptured aneurysms requiring immediate occlusion.
This page is for general education and does not replace medical advice. Treatment decisions should be made with a qualified neurosurgeon based on your individual diagnosis and imaging. To discuss your options, call Atlantic Brain and Spine Vascular Neurosurgical Care at 973.993.7772 or request a consultation.
Cerebrovascular Specialists at Atlantic Brain and Spine
Your care is provided by fellowship-trained, board-certified cerebrovascular surgeons specializing in both open microsurgery and endovascular treatment.
