Interventional neuroradiology and treatment fields

What is interventional neuroradiology?

Interventional neuroradiology is a specialization field that deals with the treatment of brain and spinal cord vascular diseases under the guidance of high technology and imaging techniques, instead of classical open surgery.

Who is an interventional neuroradiologist?

Radiology physicians who have completed six years of Faculty of Medicine and four years of residency training are required to complete an additional 2-3 year training program in order to become an interventional neuroradiologist. The number of physicians dealing with interventional neuroradiology is limited in the world and in our country due to the necessity of a long and strenuous education.

What is the basic imaging method in interventional neuroradiology?

The main imaging and treatment method is angiography.

What are the diseases treated in the field of interventional neuroradiology?

After the 1990s, rapid changes have been experienced in this field in parallel with the technological development. As a result, the field of application has expanded and the diseases that can be treated in this way have gained diversity. These patients are listed below:

Diseases treated in the field of interventional neuroradiology:

Brain aneurysm (Bubble)

Brain arteriovenous malformation (AVM; cerebral vascular bundle)

Dural arteriovenous fistula/malformation (Dural AVF)/Caroticocavernous fistula

Arterial stenosis (inside the brain and in the neck)

Acute stroke (Stroke)

Tumor embolization (vascular occlusion)

Brain aneurysms (bubble):

What are brain aneurysms (bubbles)?

Brain aneurysms are ballooning of cerebral vessels. They usually cause cerebral hemorrhage and endovascular (intravenous) treatment of aneurysms (bubbles) is one of the common procedures.

What complaint does brain aneurysm (bubble) cause and if it cannot be treated, what will be the result?

These patients usually present with cerebral hemorrhage and if left untreated, they result in death or permanent neurological damage (such as paralysis).

How is brain aneurysm (bubble) endovascular treatment done?

In this treatment, different endovascular treatment methods are used depending on the location and shape of the aneurysm. Sometimes the aneurysm is closed only by filling, sometimes this is done with the help of a balloon or by placing a stent. In some cases, the aneurysm is treated in a short time by placing a covered stent on the neck of the aneurysm in suitable patients. In rare cases, the vessel can be closed completely with the aneurysm.

Arteriovenous malformations and fistulas (AVM, Dural AVF, Vein clump):

Arteriovenous malformations and fistulas (AVM, Dural AVF, Vascular clump) and what complaints do they cause?

Treatment of congenital or acquired (usually post-traumatic) arteriovenous malformations (vascular tangles) and fistulas (abnormal/direct connection between artery and vein) in the brain, spinal cord and head and neck vessels are fully and permanently treated in suitable patients. These patients may not only come to the emergency room with cerebral hemorrhage, but also consult a doctor due to epileptic seizures, severe headaches, murmur/ringing in the ear, swelling in the eye or eyes, redness or paralysis.

How are arteriovenous malformations and fistulas (AVM, Dural AVF, Vascular clump) treated?

In endovascular treatment, the vessels are closed completely or partially in one or more sessions with appropriate occlusive materials. While some of the patients can be completely treated with this method, some of them are made suitable for surgery and/or radiation therapy. In some cases, the patient is treated through a vein by pre-planning, and the disease is completely eliminated by surgery right after.

Ballooning and stenting for arterial stenosis:

What complaints are seen in patients with neck and cerebral occlusive artery disease?

Balloon angioplasty (stenosis) and stenting procedures constitute most of the interventional neuroradiological procedures in neck and brain occlusive artery diseases. It is usually the carotid artery that is sick. These patients usually consult a doctor with neurological problems such as dizziness, imbalance, paralysis, and speech disorder.

What is the treatment of neck and cerebral occlusive artery diseases?

These patients should receive drug therapy and after a certain level of stenosis, they should be treated intravenously or surgically. Intravenous treatment (stenting) is performed while the patient is awake, especially for stenosis of the carotid artery (carotid artery) in the neck, where stenosis is common. If the vessel is in the head, the procedure is performed under general anesthesia. The treatment of these diseases is important in terms of protecting patients from stroke (Picture 3).

Acute stroke treatment

In which case is acute stroke treated?

This condition, which is caused by the sudden occlusion of the arteries feeding the brain, is treated when the patient can be transported to the hospital in the early period (first 6-8 hours). These stroke patients are evaluated urgently and in appropriate patients, the clots in the artery feeding the brain are removed by sucking, pulling out with a device or dissolving with medication.

What is the purpose of acute stroke treatment?

Treated patients are prevented from dying or remaining paralyzed.

Tumor embolization (vascular occlusion)

Preoperative (preoperative) embolization (vascular occlusion) procedures are one of the interventional neuroradiology applications in order to perform surgery in head-neck, intracranial and spinal tumors (such as nasopharyngeal angiofibroma, meningioma, hemangioma) and to prevent bleeding during the operation. These procedures are also applied as the basic treatment method in some cases.

Retinoblastoma (eye tumor) tumor treatment

In eligible patients, retinoblastoma, an eye tumor that does not benefit from intravenous tumor drug therapy and other treatment methods, can be treated through the artery.

As a result, technological developments in the devices used in imaging and treatment enable the diagnostic and treatment procedures in the field of interventional neuroradiology to become more widespread and to expand the application areas.

Related Posts

Leave a Reply

Your email address will not be published.