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Endovascular Neurosurgery

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EndovascularNeurosurgeryinIndia

Endovascular Neurosurgery or Interventional Neuroradiology is a medical speciality in which minimally invasive diagnostic and therapeutic procedures for cerebrovascular disorders are performed under radiological guidance. It is somewhat similar to the treatment carried out in the heart by cardiologists, such as angioplasty or stent placement. In these procedures, very thin or wires are placed hi catheters h i l d through h h blood bl d vessels l in i groin and navigated in the blood vessels to the site of the abnormal vessels.

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Use of Bi-plane technology - visualization in 2 planes simultaneously l l and d 3D imaging of f blood bl d vessels l Advanced Dyna CT capability enhances the ability of Endovascular surgeon to perform most accurately in delicate vascular l areas like lik brain b i .

WhyEndovascular Neuro Surgery g yatTop p HospitalinIndia

Minimal incision similar to cardiac treatment, such as angioplasty or stent placement Very thin catheters or wires placed through groin are navigated in to the blood vessels of the brain Diagnostic i i (Cerebral (C b l or Spinal S i l Angiography) A i h ) or Therapeutic h i procedures for Intracranial Aneurysms, Arterial Stenosis, Stroke (Brain attack), Arteriovenous Malformations, Vertebroplasty and Percutaneous Sclerotherapy . Tumour Embolisation is done to reduce bleeding during surgery

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ConditionsinwhichInterventional Neuroradiology/EndovascularNeurosurgeryis performed

Cerebral or Spinal Angiography : DSA (Digital Subtraction Angiography) is considered as the 'gold standard' investigation to diagnose diseases of blood vessels and is performed when a vascular disease is suspected. Intracranial Aneurysms : Introcranial Aneurysm is a weakness and ballooning of a blood vessel within the head which if left untreated, may get burst and causes its complications. Treatment is the passage of thread like platinum coils through blood vessels to the site of the aneurysm thus avoiding open surgery.

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ConditionsinwhichInterventional Neuroradiology/EndovascularNeurosurgeryis performed

Angioplasty or Stent Placement : This procedure is done to treat stenosis in arteries of brain (including carotid, vertebral, intracranial arteries). Many cases of stroke occur due to stenosis in arteries leading to brain. They can be treated non invasively by endovascular route with an angioplasty or stenting procedure. Many of these procedures are performed under local anesthesia with reduced morbidity.

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ConditionsinwhichInterventional Neuroradiology/EndovascularNeurosurgeryis performed

Stroke or Brain attack, including IntraArterial Thrombolysis : Acute stroke or brain attack usually occurs due to blockage of arteries of the brain. Appropriate patients can be treated by placing a microcatheter at the site of blockage followed by administration of thrombolytic drugs, which dissolve the blocking material. Mechanical clot removal can be done in patients even who come many after the

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ConditionsinwhichInterventional Neuroradiology/EndovascularNeurosurgeryis performed

Arteriovenous Malformation : An autriovenous malformation is a complex mass of abnormal arteries and veins located in the brain or spinal cord. During open surgery, it is often difficult to control bleeding from an arteriovenous malformation Endovascular treatment can be used to block blood flow to certain portions of the malformation that cannot be reached surgically. In such cases, patients may no longer need conventional surgery. Tumour Embolisation : One of the major problems in surgical removal of intracranial tumour is bleeding during the surgery. Interventional Neuroradiologist can help the surgeon by preoperative endovascular occlusion of the blood vessels supplying the tumour. This will reduce the bleeding and facilitate the surgery.

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ConditionsinwhichInterventional Neuroradiology/EndovascularNeurosurgeryis performed

Vertebroplasty p y and Kyphoplasty yp p y : With age, g bones become weak and collapse of bones (vertebrae) in the spine is one of the major causes of severe back pain in the elderly. Vertebroplasty is a revolutionary treatment in which "bone cement cement" is injected through a needle placed into the broken bone so as to stabilize the vertebra and to reduce the pain.

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ConditionsinwhichInterventional Neuroradiology/EndovascularNeurosurgeryis performed

Percutaneous Sclerotherapy : Many superficial vascular malformations such as Haemangioma (malformation of the blood vessels) or Lymphangiomas (malformation of lymphs) can be treated by puncturing through a needle, followed by injection of 'Sclerosant Material' which causes obliteration of the malformation.

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AdvantagesofEndovascularNeurosurgery/ InterventionalNeuroradiology gy
The endovascular approach ensures minimal injury to normal brain. I It h has f fewer complications, li i b better outcome and d ensures shorter h h hospital i l stay. Enables treatment of diseases, which could be treated in the past. Acute stroke patients can be treated even many hours after the stroke.

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