Pedro Lylyk – NeuroNews France
Pedro Lylyk’s work and accomplishments in the field of neurosurgery span decades, from a landmark intracranial stent placement in 1996 to leading the first-in-man study of a new treatment for cancer. hydrocephalus in 2022, with over 10,000 brain aneurysms and arteriovenous malformations (AVMs) treated in between. Since the mid-1980s, Lylyk has dedicated his career to developing and improving treatment options in endovascular neurosurgery, as well as training young physicians around the world. He is also currently Director and CEO of ENERI (Equipo de Neurocirugía y Radiología Intervencionista) and Clínica La Sagrada Familia in Buenos Aires, Argentina, in addition to several other titles and appointments. Here, Lylyk gives NeuroNews a window into his career and explains how the field of neurosurgery changed during this time.
What initially attracted you to medicine, and the field of neurosurgery in particular?
As far back as I can remember, I wanted to be a doctor. I knew from the start that neuroscience and the brain were so interesting, and that there was a lot to understand, develop and emerge. After completing my residency in neurosurgery, I shared with my mentors the concept of treating disease with minimally invasive therapy – a technique that was evolving at the time!
Who have been your mentors and what impact have they had on your career?
My mentors were Raúl Carrea, who is a pediatric neurosurgeon, and Charlie Drake, in neurosurgery, Julio Castaño, a neurologist, and Fernando Viñuela in interventional neuroradiology. I tried to combine the best of all these fields in this new specialty. All have been inspiring and generous teachers, not just in neuroscience, and they have also demonstrated exemplary leadership, ethics and commitment. I have been fortunate to be able to learn from my friends and colleagues around the world, to exchange ideas and experiences, to share specialized seminars, to monitor, to observe cases, to do research and to participate in numerous meetings, symposia, discussions and conferences.
You are known for placing the first intracranial stent in 1996. Can you describe the procedure and how you achieved this success?
I was performing a very difficult case of acute posterior inferior cerebellar artery (PICA) dissection and there was no other option. Fortunately, our team included interventional cardiologists, with whom we discussed the emergency case, and we decided to give the patient a chance by implanting a coronary stent, which the family agreed to. That was in 1996 and the patient is perfect to this day.
How has your postgraduate training in North America influenced you as a neurosurgeon?
I did my fellowship in Neurosurgery at University of Western Ontario in London, Canada and University of California, Los Angeles (UCLA) in Los Angeles, USA. I still remember Charles Drake’s advice today, telling me that endovascular neurosurgery had a bright future!
In your experience, how does neurosurgical practice and research differ in South America compared to other parts of the world?
Our experience in Latin America is very good. We were trained in Europe and North America and today we train many people from different countries in Latin America. The current state of medical education and the opportunities available in Latin America, however, face major challenges due to a lack of resources and the fact that funding and access are very different depending on the health system or the country.
Why did you decide to develop a training program in endovascular neurosurgery and interventional radiology in your center, and how successful have these programs been?
Since Fernando Viñuela and other young and enthusiastic neuroradiologists had founded SILAN (Sociedad Iberolatinoamericana de Neurorradiología Diagnóstica y Terapéutica), I decided that we should create our own center, the International Center for Endovascular Training (ICET). The objective was to receive and teach Ibero-Latin American doctors for at least a year, in collaboration with three other universities in Buenos Aires, since the training of doctors in interventional neuroradiology in Latin America was an imperative need. Today we also receive people from several other countries, including China, India, Japan and places in Europe. I am very proud and grateful to all of them.
What do you think has been the most important development in the field of neurosurgery during your career?
There were three particularly important steps, in my opinion:
- The Detachable Guglielmi Coil (GDC), which was introduced in the 1990s and led the endovascular treatment of brain aneurysms
- After that, intracranial stents, as a treatment for stenosis of the intracranial or carotid arteries
- More recently, flow diverters and intrasaccular flow disruptors have provided a new option for the treatment of intracranial aneurysms.
Also, today we have a better understanding of brain diseases and how best to care for these patients.
What is the greatest unmet need for neurosurgical care today?
The field of interventional oncology must evolve, this will be one of the greatest challenges in the near future.
What achievement are you most proud of in neurosurgery?
Early treatment of newborns with Vein of Galen aneurysms (a rare form of AVM in which the embryonic precursor of a vein at the base of the brain becomes dilated, causing too much blood to flow to the heart ). My team and I have performed these treatments over many years, with a difficult but improved technique, in our center in Buenos Aires.
Besides your own work, what is the most interesting neurosurgical research you have seen in the past year?
Besides endovascular neurosurgery, the most interesting future prospect is the development of new techniques for non-vascular diseases such as hydrocephalus via the endovascular route. This is a new and exciting project that I am working on today with my colleagues Adel Malek and Karl Hellman from CereVasc and Tufts University (Somerville, USA). As the principal investigator of the first-in-man ETCHES I study, I have previously published a case report detailing early treatments for communicating hydrocephalus with the eShunt System (CereVasc) in the Journal of NeuroInterventional Surgeryand the first normal pressure hydrocephalic patient was also recently treated with the device at Clínica La Sagrada Familia.
What advice would you give to people embarking on a career in neurosurgery?
Our field has grown very quickly, but there are still plenty of opportunities to learn and improve. Younger generations have to study hard and enjoy many innovations and interactions between different fields, while the study of anatomy, physiology and pathology is also very important. The new generation must think outside the box in order to improve the quality of life of our patients as well.
What are your interests outside of medicine?
Outside of medicine, my interests are studying history, tennis, and traveling with my family – my wife, Sandra Boreisink, and my three wonderful children, Ivan, Pedro Nicolás, and Natalia. Since my childhood, I was a dancer in the Ukrainian ballet in Argentina and ended up being its director. Today, I really enjoy opera and watching classical ballet at the Teatro Colón in Buenos Aires. As a Ukrainian descendant, I am also proud to be the Honorary Consul of Ukraine in Buenos Aires, and I have chaired the Argentine Representation of Central Ukraine (RCU-Representación Central Ucrania) since 2011.
- Neurosurgeon, Director and CEO, ENERI (Equipo de Neurocirugía y Radiología Intervencionista) and Clínica La Sagrada Familia, Buenos Aires, Argentina
- Chair of Neurosurgery and Hemodynamics, University of Buenos Aires (UBA)
- Professor and Director, Department of Vascular Medicine, Universidad del Salvador (USAL)
- Professor and holder of the Chair of Endovascular Surgery, Universidad de Ciencias Sociales y Empresariales (UCES)
- MD, Faculty of Medicine, UBA
- Pediatric Neurosurgery Residency, Ricardo Gutiérrez Children’s Hospital
- Fellowship in Diagnostic Neuroradiology, Therapeutic and Endovascular Neurosurgery, University of Western Ontario, London, Canada and University of California, Los Angeles (UCLA), Los Angeles, USA
- 2009: Master in Neurosurgery, World Federation of Neurosurgical Societies (WFNS)
- 2011: “Exceptional personality in science”, legislature of Buenos Aires
- 2015: First Tribute to Men and Women in Health, Health Prize, UCES
- 2018: First non-Spanish physician distinguished as an honorary member, Official College of Physicians, La Coruña, Spain
Lylyk is also a co-founder of the Cerebrovascular Research and Education Foundation (CREF) Educational Grant, which enables young physicians, technologists and nurses from around the world to attend the World Live Neurovascular Conference (WLNC) – the case discussion the most intense and educational live. platform that revolves around the world from one continent to another every year.