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NeuroIntervention Procedures

CEREBRAL ANEURYSM

A cerebral aneurysm, also known as an intracranial aneurysm or brain aneurysm, is a weakened or bulging area in the wall of a blood vessel within the brain. It occurs when the constant pressure of blood flow causes a localized dilation, forming a balloon-like bulge. Cerebral aneurysms can vary in size and shape, ranging from small and unruptured to large and potentially life-threatening.

Aneurysm Flow Diverter

Aneurysm flow diversion is a minimally invasive procedure used to treat complex or wide-necked cerebral aneurysms. It involves placing a stent-like device called a flow diverter across the neck of the aneurysm. The flow diverter is designed to divert the blood flow away from the aneurysm, promoting the formation of a clot within the aneurysm and effectively excluding it from the circulation. This procedure helps to prevent rupture and reduce the risk of reoccurrence.

Aneurysm Coiling

Aneurysm coiling, also known as endovascular coiling or coil embolization, is a minimally invasive procedure used to treat cerebral aneurysms. It involves inserting a catheter into the blood vessel, navigating it to the aneurysm, and placing small platinum coils within the aneurysm sac. These coils promote blood clotting and create a barrier that prevents blood from entering the aneurysm, reducing the risk of rupture.

Aneurysm Stent/Balloon Assisted Coiling

Aneurysm stent/balloon assisted coiling is a technique used to enhance the effectiveness of aneurysm coiling. During the procedure, a stent or balloon is deployed within the parent blood vessel adjacent to the aneurysm. The stent or balloon provides support and acts as a scaffold, helping to keep the coils in place and promote their stability within the aneurysm. This technique is often used for wide-necked or complex aneurysms that may be challenging to treat with standard coiling alone.

Intra-Aneurysm Device

Intra-aneurysm devices are specialized devices designed to be placed within the aneurysm to promote clotting and prevent rupture. These devices come in various forms, such as flow disrupters, stents, or flow diverters. They are deployed within the aneurysm sac, altering blood flow patterns and encouraging the formation of a clot. By blocking the blood flow into the aneurysm, intra-aneurysm devices help to reduce the risk of rupture and provide long-term stability to the aneurysm.

BRAIN & SPINE ARTERIOVENOUS MALFORMATION (AVM/AVF)

Brain and spine arteriovenous malformation (AVM) is a rare abnormality in the blood vessels that involves a tangle of arteries and veins in the brain or spinal cord. Normally, arteries carry oxygen-rich blood away from the heart, and veins return oxygen-depleted blood back to the heart. However, in an AVM, there is a direct connection between arteries and veins without the usual capillary network in between.

Onyx/Squid Embolization

Onyx/Squid embolization is a technique used in endovascular procedures to treat vascular malformations such as arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs). It involves the injection of a liquid embolic agent called Onyx or Squid through a catheter directly into the abnormal blood vessels. Onyx/Squid is a non-adhesive liquid polymer that solidifies upon contact with blood, leading to vessel occlusion and preventing further blood flow within the malformation. This embolization technique helps to reduce the risk of bleeding, manage symptoms, and prepare the patient for further treatment, such as surgery or radiosurgery.

Glue Embolization

Glue embolization, also known as cyanoacrylate embolization, is a procedure used to treat certain vascular abnormalities, including AVMs and AVFs. It involves the injection of a medical-grade glue, such as N-butyl cyanoacrylate (NBCA), through a catheter into the affected blood vessels. The glue rapidly polymerizes upon contact with blood, creating a solid embolus that blocks the abnormal vessels and reduces blood flow. Glue embolization is an effective method for occluding abnormal vessels, particularly those that cannot be treated with other embolic agents. It is often used in conjunction with other treatment approaches, such as surgery or radiosurgery, to enhance the overall management of the vascular malformation.

INTERCEREBRAL HEMORRHAGE

Intracerebral hemorrhage (ICH) is a type of stroke that occurs when there is bleeding within the brain tissue itself. It is usually caused by the rupture of a blood vessel, leading to the accumulation of blood in the surrounding brain tissue. ICH is a serious condition that requires immediate medical attention.

Subarachnoid Hemorrhage (SAH) Management

Subarachnoid hemorrhage (SAH) refers to bleeding that occurs in the space between the brain and the thin tissues that cover it (subarachnoid space). It is most commonly caused by the rupture of a cerebral aneurysm. SAH is a medical emergency that requires prompt evaluation and management. The main goals of SAH management include stabilizing the patient, identifying and treating the underlying cause (such as an aneurysm), and preventing complications. Treatment may involve neurosurgical interventions such as aneurysm clipping or endovascular coiling, along with supportive care, including blood pressure control, fluid management, pain management, and monitoring for potential complications such as vasospasm.

Brain AVM (Arteriovenous Malformation)

A brain arteriovenous malformation (AVM) is an abnormal tangle of blood vessels in the brain. It consists of a direct connection between arteries and veins, bypassing the capillary network. Brain AVMs can cause various symptoms, including seizures, headaches, and neurological deficits. The management of brain AVMs depends on several factors, including the size, location, and associated symptoms. Treatment options include embolization, surgical removal (resection), stereotactic radiosurgery, or a combination of these approaches. The goal of treatment is to eliminate the AVM and prevent potential complications, such as hemorrhage or neurological deficits.

Ruptured Brain Aneurysm

A ruptured brain aneurysm refers to the sudden rupture of a weakened area in a blood vessel within the brain, leading to bleeding into the surrounding area. It is a life-threatening condition that requires immediate medical attention. The management of a ruptured brain aneurysm involves stabilizing the patient, controlling bleeding, and preventing further complications. Treatment options include surgical clipping (placing a clip around the neck of the aneurysm) or endovascular coiling (placing coils within the aneurysm to promote clotting). The choice of treatment depends on several factors, including the aneurysm's location, size, and the patient's overall health.

Brain Dural AVF (Arteriovenous Fistula)

A brain dural arteriovenous fistula (AVF) is an abnormal connection between arteries and veins in the brain, bypassing the normal capillary network. It is typically a congenital condition, meaning it is present at birth. Brain AVFs can cause symptoms such as headaches, seizures, and neurological deficits. The management of brain AVFs depends on the specific characteristics of the fistula, including its location, size, and associated symptoms. Treatment options may include endovascular embolization, surgical resection, stereotactic radiosurgery, or a combination of these approaches. The goal of treatment is to close off the abnormal connection and restore normal blood flow patterns.

CAROTID VERTEBRAL AND INTRACRANIAL STENOSIS and STENTING

Carotid, vertebral, and intracranial stenosis refer to the narrowing or blockage of blood vessels that supply blood to the brain. These conditions can disrupt blood flow and increase the risk of stroke or transient ischemic attacks (TIAs), also known as "mini-strokes."

Carotid Stenosis

Carotid stenosis occurs when the carotid arteries, which are located in the neck and supply blood to the brain, become narrowed or blocked due to the buildup of plaque (atherosclerosis). Common causes include high cholesterol, high blood pressure, smoking, and diabetes. Carotid stenosis is a significant risk factor for ischemic stroke. Management options include lifestyle modifications, medication to control risk factors, and in severe cases, carotid endarterectomy (surgical removal of the plaque) or carotid artery stenting (placing a stent to widen the narrowed artery).

Vertebral Stenosis

Vertebral stenosis refers to the narrowing of the vertebral arteries, which are located in the neck and supply blood to the back of the brain. Similar to carotid stenosis, it is typically caused by atherosclerosis. Vertebral stenosis can increase the risk of stroke or TIAs, particularly in the posterior circulation of the brain. Treatment options are similar to carotid stenosis and may include lifestyle changes, medication, or surgical interventions such as vertebral artery bypass or angioplasty.

Intracranial Stenosis

Intracranial stenosis involves the narrowing of the arteries within the brain itself. It is often caused by atherosclerosis or the buildup of plaque within the arteries. Intracranial stenosis can increase the risk of stroke, particularly in the affected area of the brain. Treatment options include lifestyle modifications, medication to manage risk factors, and in some cases, endovascular procedures such as angioplasty (widening of the narrowed artery using a balloon) or stenting (placing a stent to keep the artery open).

Intracranial Stenosis (ICAD)

ICAD occurs when fatty deposits, cholesterol, and other substances accumulate on the inner walls of the arteries, forming plaque. The exact cause of ICAD is not fully understood, but it is thought to develop due to a combination of genetic and environmental factors. Risk factors for ICAD include hypertension (high blood pressure), diabetes, high cholesterol, smoking, and a family history of stroke or cardiovascular disease.

Carotid Artery Stenting

Intracranial stenosis involves the narrowing of the arteries within the brain itself. It is often caused by atherosclerosis or the buildup of plaque within the arteries. Intracranial stenosis can increase the risk of stroke, particularly in the affected area of the brain. Treatment options include lifestyle modifications, medication to manage risk factors, and in some cases, endovascular procedures such as angioplasty (widening of the narrowed artery using a balloon) or stenting (placing a stent to keep the artery open).

Vertebral Artery Stenting

Intracranial stenosis involves the narrowing of the arteries within the brain itself. It is often caused by atherosclerosis or the buildup of plaque within the arteries. Intracranial stenosis can increase the risk of stroke, particularly in the affected area of the brain. Treatment options include lifestyle modifications, medication to manage risk factors, and in some cases, endovascular procedures such as angioplasty (widening of the narrowed artery using a balloon) or stenting (placing a stent to keep the artery open).

Vascular Artery Stenting

ICAD occurs when fatty deposits, cholesterol, and other substances accumulate on the inner walls of the arteries, forming plaque. The exact cause of ICAD is not fully understood, but it is thought to develop due to a combination of genetic and environmental factors. Risk factors for ICAD include hypertension (high blood pressure), diabetes, high cholesterol, smoking, and a family history of stroke or cardiovascular disease.

ACUTE ISCHEMIC STROKE

Acute ischemic stroke refers to a sudden loss of blood flow to a part of the brain, resulting in a lack of oxygen and nutrients to the affected area. It is the most common type of stroke, accounting for about 85% of all stroke cases. Acute ischemic stroke requires immediate medical attention as timely treatment can help minimize brain damage and improve outcomes.

Intravenous thrombolysis

The administration of a clot-dissolving medication called tissue plasminogen activator (tPA) within a specific time window after the onset of stroke symptoms.

Mechanical thrombectomy

This procedure involves the use of a catheter-based device to physically remove the clot causing the blockage, primarily used for larger vessel occlusions.