Endovascular neurosurgery is a subspecialty within neurosurgery that uses catheters and radiology to diagnose and treat various conditions and diseases of the central nervous system. The central nervous system is made up of the brain and the spinal cord.
Why Endovascular NeuroSurgery at Super Speciality Hospitals in India
- Use of Bi-plane technology - visualization in 2 planes simultaneously and 3D imaging of blood vessels
- Advanced Dyna CT capability enhances the ability of Endovascular surgeon to perform most accurately in delicate vascular areas like brain
- 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 (Cerebral or Spinal Angiography) or Therapeutic procedures for Intracranial Aneurysms, Arterial Stenosis, Stroke (Brain attack), Arteriovenous Malformations, Vertebroplasty and Percutaneous Sclerotherapy
- Tumour Embolisation is done to reduce bleeding during surgery
Advantages of Endovascular Neurosurgery/ Interventional Neuroradiology
- The endovascular approach ensures minimal injury to normal brain.
- It has fewer complications, better outcome and ensures shorter hospital stay.
- Enables treatment of diseases, which could be treated in the past.
- Acute stroke patients can be treated even many hours after the stroke.
Conditions in which Interventional Neuroradiology/Endovascular Neurosurgery is 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
Aneurysms are focal swelling of blood vessels, which can burst and cause bleeding in the brain. Endovascular coiling can treat these aneurysms, thus avoiding open surgery. Studies have shown that coiling treatment leads to better outcomes as compared to open surgical clipping.
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.
Stroke or Brain attack, including Intra-Arterial Thrombolysis
Acute stroke or brain attack usually occurs due to blockage of arteries of the brain. Appropriate patients can be treated by placing a micro-catheter 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 stroke.
Arteriovenous Malformation
Arteriovenous Malformation (AVMs) of brain are malformed swollen blood vessels, which can cause bleeding in brain, seizures and headache. AVMs can be treated by injecting "glue" or "onyx" through a microcatheter placed precisely into these abnormal blood vessels.
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.
Vertebroplasty and Kyphoplasty
With age, 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" is injected through a needle placed into the broken bone so as to stabilize the vertebra and to reduce the pain.
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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