Interventional Radiology

Interventional Neuroradiology, also known as Endovascular Neurosurgery, Interventional Neurology, or Neurointervention refers to a set of minimally invasive techniques of treating certain vascular diseases of the head and spine. It is one of the most technologically advanced medical field and demands very high levels of disease understanding, in-depth subject knowledge, highly skilled sets of hands, courage, academic orientation, philosophy and ability to look into the future. The training of neurointerventionists involves radiological work, clinical neurology, ICU management and cathlab work. It is a truly interdisciplinary medical field. The initial discovery of neuro-angiography was made by Egas Moniz, a neurophysician, with significant contributions from Japanese neurosurgeons. However later on, the field was further developed, techniques perfected and guidelines were defined by neuroradiologists. With the advent of better equipments and infusion of high end technology, the ability to do therapeutic procedures has increased drastically over the last 25 years. This has also brought about the interest of neurologists and neurosurgeons to this field, thereby resulting in a truly dynamic amalgamation of various fields and thoughts.

Diseases typically dealt by Interventional Neuroradiologists:

• Brain hemorrhage
• Stroke ('Brain attack'/paralysis)
• Acute stroke
• Recurrent stroke or transient ischemic attacks
• Arterial dissection
• Vascular malformations of brain and spine (AVM and Dural AVF)
• Cranio-facial vascular malformations
• Venous sinus thrombosis, occlusion or stenosis
• Brain and spinal tumors

List of procedures performed

• Various diagnostic angiograms (DSA) for head, neck and spine (cerebral DSA, carotid DSA, spinal DSA)
• Aneurysm coiling: simple, balloon assisted, stent assisted
• Spasmolysis: treatment for vasospam developing in the course of subarachnoid hemorrhage
• Arterio-venous malformation embolization
• Dural arterio-venous fistula embolizaation
• Preoperative or curative embolization of tumors located in head, face, neck and spine
• Treatment of epistaxis (bleeding from nose)
• Treatment of uncontrolled bleeding after trauma/injury to head, neck and face
• Carotid artery angioplasty with stenting
• Vertebral artery angioplasty with stenting
• Angioplasty and stenting for intracranial arterial stenosis
• Intra-arterial thrombolysis and thrombectomy in cases of acute stroke
• Inferior petrosal sinus sampling for Cushing's syndrome and disease
• Intracranial venous stenting for stenosis and intracranial venous hypertension
• Acute intracranial dural venous sinus thrombosis treatment
• Direct percutaneous embolization for cranio facial vascular malformations and tumors
• Vertebral hemangioma embolization