Stroke Treatment and Prevention
What is a mechanical thrombectomy?
Mechanical thrombectomy is the use of minimally invasive tools to treat ischemic stroke. Ischemic strokes occur as the result of a blockage in the arteries restricting blood supply. TIIA’s team of skilled interventional radiologists can make a small incision in the groin and use micro catheters to access the blockage in the patient’s brain. Some of the tools are referred to stent retrievers; essentially these devices can take hold of the clot or blockage and then be used to pull it out. Other tools use suction to remove the clot and restore blood flow. Mechanical thrombectomy can be used in concert with intra-arterial pharmalogic thrombolysis (IA tPA) or not, depending on the patient’s last seen well time. Pharmologic thrombolysis (tPA) is the use of IV drugs to treat ischemic stroke. As long as the patient has been seen behaving normally within four hours of symptom onset, the IA tPA can be used. If the last seen well time is greater than four hours, then the mechanical thrombectomy is performed without the drug.
Endovascular Stenting and Balloon Angioplasty
What is Balloon Angioplasty?
Balloon angioplasty is used to open a blocked vessel. The balloon is delivered via a catheter and then inflated once it is deployed in the targeted area. The interventional radiologists deploy the balloon by first making an incision in the thigh and then using x-ray imaging to fine monitor their progress as they deliver the balloon through the femoral artery and into, usually, the carotid artery. Once in place, the balloon is inflated and this allows blood to flow through the now larger space. The balloon does not permanently remain in the vessel.
What is Endovascular Stenting?
Endovascular stenting, on the other hand, provides a permanent way to open the vessel. The stent can be used in conjunction with a balloon. The balloon can be inflated and the stent, basically a small tube, can be placed to hold the vessel walls open. During a stroke, if the vessels are perceived by the doctor to be too narrow, too blocked, or susceptible to further blockages a stent can be placed in order to allow blood to flow more freely and continuously.
Arteriovenous Malformation (AVM) Embolization
What is a brain AVM?
Arteriovenous malformations (AVMs) of the brain are abnormal connection between arteries and veins that carry blood to and from the brain. AVMs are most common in young adults and can be very dangerous because they may cause bleeding in or around the brain. People are born with AVMs but they do not seem to be inherited. It is thought that brain AVMs may be caused by a rupture or clotting of a blood vessel during development of a baby.
How does embolization treat a brain AVM?
Embolization is a method to cut off blood supply to the AVM. After a neurological exam is performed to see what blood vessels supply the AVM with blood and if they also supply other parts of the brain, a catheter is inserted into the blood vessels surrounding the AVM and a permanent adhesive material is injected to close the vessels.
Other Neuro Interventional Procedures
What is a cerebral angiogram?
A cerebral angiogram uses x-ray imaging guidance to insert a catheter and inject a contrast material into blood vessels in the brain. Then images are taken with x-rays in order to examine any abnormalities such as aneurysms and diseases.
Cerebral Aneurysm Embolization
What is an aneurysm?
An aneurysm is a sac that develops in an artery because the vessel wall is weak. An aneurysm in the brain may put pressure on surrounding nerves and brain tissue resulting in nerve paralysis, headaches, neck and upper back pain as well as nausea and vomiting.
How does embolization treat an aneurysm?
If an aneurysm is found during the cerebral angiogram (see above), a smaller catheter is inserted into the catheter already in place where metal coils are deposited into the aneurysm. The coils block blood flow to the aneurysm and prevent it from rupturing.