Cerebral angiography is a procedure that allows exquisite X-ray pictures of the blood vessels of the brain to be taken. These are higher in resolution and provide flow information that cannot be obtained from a CT or MRI scan. Through a very small incision in the groin, a catheter (long polymer tube) is placed into the blood stream and navigated into the blood vessels in the neck. With the catheter in an artery in the neck, X-ray pictures are taken while contrast is injected into the artery through the catheter, yielding an angiogram.
Intraarterial thrombectomy has also become a popular treatment option by interventionalists, who commonly extract an intraarterial clot with a suction catheter.
Intraarterial thrombolysis and thrombectomy are highly specialized procedures performed by an interventional radiologist.
Thrombolysis is the administration of clot-dissolving medication, which can be injected into a peripheral vein, usually in the arm (intravenous) or into an artery via a catheter, which is advanced from the groin into the brain (intraarterial).
Endovascular embolization involves a catheter being inserted into the femoral artery in the groin and positioned within the brain. Through the catheter, platinum coils, Onyx, or glue will be placed into the blood vessel abnormality to prevent blood from entering it.
Angioplasty and stenting involves placing a catheter that incorporates a special balloon across a narrowed blood vessel segment. Inflating the balloon stretches the narrowed blood vessel open. A stent (a tubular metallic mesh) is then placed into the blood vessel to keep it from narrowing again.