Interview with Dr Dulce Bonifacio

LINNC online caught up with Dr Dulce Bonifacio who won the “Best Case Report by a Participant” at LINNC New York Seminar 2018 and spoke with her about her passion for her specialty and her experiences professionally and at LINNC …

What was your impression of the recent LINNC NY meeting?

The 2018 edition of the LINNC New York Seminar was excellent, all the issues addressed are of great interest for our daily practice and the way in which the cases are presented by Professors Moret and Spelle is very didactic and enjoyable. I attended the Paris course in 2013, 2014 and 2017 in addition to the Singapore course in 2016 and all have been of great importance for my daily practice.

Could you briefly describe your case? - Watch it now!

It was a complex case because the patient is a doctor on my work team and was technically difficult as well because it was an aneurysmatic dilation dependent on a left pontine artery associated with a small arteriovenous malformation with very fast drainage to the transverse sinus.  It was not possible to advance a microcatheter or coils distally and the patient's condition was critical because he suffered subarachnoid hemorrhage Fisher 4. Surgery was not an option, so it was necessary to do an endovascular procedure to avoid possible re-bleeding.

I decided to do it with hystoacril because it is the oldest liquid embolic agent, I have experience using it, any catheter can be used after flushing dextrose and there is very fast polymerization suitable for high flow situations.

The angiographic result and clinical outcome were excellent.

Is there anything about the specificity of your education and the country where you practice that you would like to speak about?

In Mexico we do not have a public stroke program. In addition, access to devices for neuro-interventional procedures in general is limited, so we have to make our best effort to treat our patients with a lesser amount of resources.

In terms of education, in Mexico you have to finish your medical studies and then do a full specialty in radiology, then neuroradiology and finally interventional neuroradiology, which requires a fellowship of eight years.

Why did you choose your specialty?

When I first saw an angiography room, I fell in love with minimally invasive techniques. First, I saw a cardiology procedure and I liked it, but when I realized that severe neurological disorders could be resolved in this way I was impressed. This made me decide to do my best to learn this technique, which from my point of view represents one of the most important advances in medicine since it allows severely ill patients to recover their health and remain functional and productive. 

Do you see an increase in women neurointerventionists?

Not really, maybe because it requires a long fellowship. In Latin America, women, regardless of their profession, have greater responsibility for the care of the home and children.

What can be done to increase the percentage of women in your specialty?

The gender role modification to equity, the support we can give each other among women and the recognition of our abilities by our male colleagues all will help stimulate more women so that they can develop fully in this area.

What are your future goals and areas of interest?

My passion is stroke, however my daily practice has primarily focused on the treatment of ruptured aneurysms because for the last six years I have unsuccessfully tried to implement in my hospital a stroke program. I will continue to knock on doors, but maybe I have to consider the possibility of finding another place where I can develop a stroke treatment program.