Get to Know: Neurosurgeon Ryan Kellogg, MD

At a Glance

  • Title: Assistant Professor
  • Fellowship: University of Washington
  • Residency: Medical University of South Carolina

Ryan Kellogg, MD, is a neurosurgeon who is driven by the potential of combining computers and technology with medicine to improve healthcare. He specializes in cerebrovascular neurosurgery, which involves using both open, micro neurosurgery techniques and endovascular techniques to treat vascular pathology of both the brain and spine.

What are some of the most common cerebrovascular diseases you treat?

Intracranial aneurysms are probably one of the most frequent pathologies I treat in both an elective and emergent fashion. Strokes, both hemorrhagic and ischemic, are also becoming more common as recent studies have proven benefits for surgical management of these diseases. 

I treat brain tumors with both endovascular and microsurgical techniques. Many tumors are extremely vascular, and pre-operative blockage of the blood supply reduces blood loss during the surgery and makes the surgery safer for the patient. Another extremely common neurosurgical disease, chronic subdural hematomas, is now being treated through endovascular means. Other diseases that are somewhat common include carotid stenosis, intracranial arteriovenous malformations, dural arteriovenous fistulas, spinal AVMs and fistulas.

What are the advantages of using microsurgery and endovascular techniques to treat cerebrovascular diseases?

Perhaps the biggest advantage is the opportunity to provide the patient the best surgical treatment based on their unique pathology. The ability to tailor the approach and having an understanding of both options helps to provide the patient the best care. 

For example: Brain aneurysms, historically treated with microsurgery, are now more frequently being treated with endovascular surgery. As newer endovascular devices are developed, the safety and outcomes of aneurysm treatment have improved, and in many circumstances prove to be the best option for the patient. However, there are still certain aneurysms, based on location or size and in combination with other patient factors, which benefit from microsurgery. 

Also, many cerebrovascular diseases require and/or benefit from both microsurgery and endovascular surgery. Intracranial arteriovenous malformations are a good example where multidisciplinary care is the best choice. For a given AVM, the ability to choose which arteries to block off with endovascular surgery prior to taking the patient to open surgery is a significant benefit to making a relatively complex procedure safer for the patient.

Prior to medical school, you worked in a medical simulation lab. What did you learn from that experience?

During college, I worked in a medical simulation lab part time and enjoyed seeing the intersection of technology and medicine. I grew up playing sports and coaching, so working in a lab that applied my interest in medicine and technology to teach/train was ideal. After graduating from college, I took a full-time job as the lab manager and helped with research studies, daily training activities and outreach to middle school and high school students. It was very rewarding to witness the development of new surgical and training technologies at an early stage.

You are the co-founder of a medical device company. Can you share how that company came about and the types of devices you’ve developed? 

During my first year of neurosurgery residency, I was surprised at how old some of the technology was that we relied on for critical parts of our procedures. In particular, the image guidance or “neuro navigation” technology was very dated. The hardware was large and bulky, the software was not user friendly, and frequently the devices were often not used due to shortcomings that could be solved with modern technology. Additionally, at this time both virtual reality and augmented reality headsets were an emerging technology, and these display systems, with their sensors and hardware, could solve many of the issues. 

I started a company with a friend from college to pursue development of the technology. We have been granted two patents for the core technology and we are working on further development. Hopefully, we will get the device to a stage where we can conduct trials, but the device is not yet ready for clinical use.

Why did you choose to specialize in neurosurgery — and endovascular surgery in particular?

Growing up, I read a lot of Michael Crichton and was captivated by his book “Terminal Man.” Between the futuristic science in that novel and “The Matrix,” I became very interested in the idea of how the brain can interface with computers, and I decided to study neurobiology in college. So, going into medical school I had already set my mind on pursing neurosurgery. 

Ultimately, I came to realize that I enjoyed the technical challenges of complex cerebrovascular cases over the type of work involved in functional neurosurgery, where I would have had more involvement with brain machine interfaces. As I began neurosurgical training, I noticed that much of the cerebrovascular surgery was moving to endovascular techniques. The cerebrovascular team was a very innovative group of both neurosurgeons and interventional neuroradiologists. They were pushing the envelope, involved in a large number of major national and international trials, and were helping to develop devices that are now FDA approved and routinely used in stroke and aneurysm treatment. I quickly realized that, like cardiac surgery, traditional open surgical procedures were going to be replaced by minimally invasive techniques that have the potential to provide better outcomes with improved safety. 

What about UVA attracted you? 

Definitely one of the biggest reasons I was attracted to UVA was the tremendous reputation of the neurosurgery department. In my field, the neurosurgery department at UVA is very well recognized both nationally and internationally as providing great patient care, training leaders in the field and attracting excellent trainees. I have always wanted to work in academics, to have the opportunity to teach residents and to be in an environment that fosters innovation. 

With the field of neurosurgery being rather small, I was fortunate to have multiple mentors recommend the institution based on their interactions with the faculty here. Finding a job where I had great endovascular partners and a chairman that supported my academic interests was also very important; these were areas where UVA stood out to me. 

How would you characterize your relationship with referring providers? 

My goal is to ensure that when a referring provider sends a patient to me for care, I provide the appropriate treatment for the patient, and that the treatment plan is also communicated back to the referring provider. I strongly believe that healthcare is like a team sport, and success requires teamwork and good communication. I realize that neurosurgical diseases are some of the rarer and unique problems, and being readily available to referring providers to assist with their patients is of the utmost importance to me.

To refer a patient to UVA Neurosurgery, call UVA Physician Direct at 800.552.3723.