Endovascular Services

In recent years, many of vascular diseases are treated with minimally invasive techniques. Techniques such as endovascular surgery have gain popularity by providing an alternative to traditional open surgery.  Endovascular surgical approach to treat vascular diseases and abnormalities result in less pain, less scar tissue, less recovery time, and reduce operation and post-operation costs. In many cases, endovascular techniques can provide options that are not available to open surgery.  However in acute stoke cases, rapid selection of appropriate candidates for endovascular treatment options is also the key to the success of the outcome of the treatment. In many cases, if a stroke patient receives proper treatment within 3 hours onset of stroke, the damage is completely reversible.

Endovascular approach for treating cerebrovascular diseases and abnormalities entails insertion of a guide catheter through one of the femoral arteries and navigating the catheter into one of the carotid or vertebral arteries. The procedure is performed under a special X-ray technique (angiography).  A microcatheter is then advanced through the guide catheter into the lesion in the brain. For the case of ischemic stroke, clot busting drug (t-PA) will be delivered through the microcatheter into the lesion.  Microcatheters are also used for angioplasty and stenting procedures to open up a blocked artery. During embolization of an aneurysm, a microcatheter is used to deliver some tiny micro coil into the aneurysmal pouch (the procedure is called coiling an aneurysm).  In some cases, the aneurysm neck is too large that would be hard to contain the coil inside the aneurysm. To overcome this problem, a stent is first deployed to partially cover the neck of the aneurysm. Then, a microcatheter tip is navigated through the stent into the aneurysm.  Once the microcatheter is positioned inside the aneurysm, the coils are delivered to fill up the aneurysmal pouch.  The procedure is done in about an hour while the patient is awake.

Treatments Provided at the Stroke Center Include:

• Carotid angioplasty and stent placement
• Intra-cranial angioplasty and stent placement
• Intra-arterial thrombolysis
• Intra-cranial aneurysm and AVM treatment
• Management of intra-cranial hemorrhage
• Embolization of tumors
• Intra-arterial chemotherapeutic agents for malignant tumors
• Secondary prevention of stroke
• Endovascular treatment of intracranial venous disorders
• Specialized Stroke Intensive Care Unit.

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Stent and coiling procedure for treating a sidewall aneurysm.

One of the major blood vessels of the brain is blocked causing a stroke (the arrow shows the location of the blockage)

After intra-arterial thrombolysis therapy, the blockage is removed and normal blood flow to the brain is restored.