Interventional Radiology
Vascular imaging, otherwise known as angiography, is an x-ray technology that enables physicians to see a patient's blood vessels Conducting an angiogram involves placing a small flexible catheter or tube into the blood vessels for injection of contrast material (x-ray dye). An arteriogram involves the study of arteries; a venogram is the study of veins. All are conducted by specially trained radiologists called angiographers.
During the testing, you will be connected to an EKG, blood pressure and pulse oximeter monitors. Your groin area will be shaved and sterilized and the area where the catheter is to be inserted will be numbed. You should feel little to no discomfort and will be able to watch much of the procedure on a television screen.
After the dye is injected, you will be positioned for x-ray filming. (It is not uncommon to feel flushed or warm when the dye is injected.) It is important to relax and remain motionless to get a clear set of images. A series of several films may be necessary. The process will take several hours, depending on the number of images required.
If you experience an itching sensation, shortness of breath, a wave of nausea or any other reaction to the contrast material, alert your nurse or technologist.
Following the procedure, rest according to your doctor's instructions. You will be instructed to drink plenty of fluids to help the kidneys and the bladder flush the contrast out of your bloodstream. The results will be explained to you by your doctor. It generally takes at least 72 hours for him or her to get and review the results.
Treatment
Interventional neuroradiology manages cerebrovascular diseases by using specialized catheters to treat problems within the blood vessels. It is a minimally invasive technique that is intended to be a complement to the vast array of surgical and medical therapies.
Cerebral Aneurysms
An aneurysm is a localized area of weakening on a blood vessel. Such areas are prone to rupture, potentially resulting in serious neurologic damage. A ruptured aneurysm is an emergency requiring intensive patient support, including planning for direct treatment of the aneurysm to prevent further bleeding. Standard therapy for cerebral aneurysm is open brain surgery, with application of a clip to close the aneurysm. Recently developed techniques in interventional neuroradiology allow closure of the brain aneurysm from within the blood vessel, eliminating the need for open surgery. The GDC system is a coil system specifically designed for use in brain aneurysms, and it serves as a viable complement to open surgical techniques in select patients.
Cerebral Arteriovenous Malformations
Catheter techniques and their supportive technology allow the navigation of small catheters to areas of arteriovenous miscommunication/malformation within the brain circulation. The closure of these vessels may allow complete cure of a lesion or may make future surgical re-section safer.
Stroke Therapies
Interventional neuroradiology can assist in the management of acute stroke. Catheters can be navigated within the brain circulation to the point of occlusion, after which clot-dissolving drugs can be administered.
Balloon angioplasty techniques, similar to those used in cardiac catheterization, can also be used to treat areas of significant vascular narrowing, resulting in improvement of cerebral blood flow.
Tumors of the Head and Neck
Radiology-guided microcatheters can be used to gain access to the blood circulation site for a tumor and then embolize it (cut off the blood flow to that area). Occluding the blood supply in this way can reduce the surgical risks or can be used as a palliative treatment to limit the tumor's growth. The select access this process allows can also be used to precisely deliver high-dose chemotherapy.
Research
Currently in development is the use of intracranial stents (similar to those used in cardiac catheterization) to help improve blood circulation.
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