Treatment of Acute Stroke
Interventional neuroradiologists are an integral part of the stroke team
at Hoag Hospital. As part of the Code 20 initiative, patients suspected
of having an acute stroke are rapidly triaged through the Emergency Room
so they can undergo an emergent CT scan (see Advanced Neuroimaging for
further detail). Immediately after the scan is performed, the radiologist
discusses the results with the patient's neurologist and ER physician.
Depending on the circumstances of the patient's condition, he or she
may be a candidate for thrombolysis which 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). Intraarterial thrombectomy has
also become a popular treatment option by our Interventionalists. We commonly
extract intraarterial clot with a suction catheter. Intraarterial thrombolysis
and thrombectomy are highly specialized procedures performed by an Interventional
radiologist. Many new and exciting advances in endovascular treatment
of stroke are coming our way. The Hoag NeuroInterventionalists remain
poised to introduce these new innovations as they become available.
Treatment of Cerebral Aneurysms and Vascular Malformations
Cerebral aneurysms are abnormal balloon-like outpouchings of blood vessels
within the brain. Depending on their location, size, and patient risk
factors, they are at risk of rupturing and causing intracranial hemorrhage.
These aneurysms can often be treated non-invasively using endovascular
embolization performed by a highly specialized Interventional neuroradiologist.
Similar to a conventional angiogram, a catheter will be inserted into
the femoral artery in the groin and positioned within the brain. Through
the catheter, metallic coils and possibly a stent will be placed within
the aneurysm to prevent blood from entering it.
Endovascular embolization can also be performed in some patients with
vascular malformations (specifically arteriovenous malformations, or AVMs)
using metallic coils and/or glue.