Interventional Neuroradiology

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.