Many of today’s surgical procedures are so advanced and precise, they would have been considered unimaginable only a few decades ago. One of those procedures is endovascular neurosurgery, which is a way to treat conditions and diseases of the central nervous system (brain and spinal cord).
You would assume that to treat conditions of the head, neck, and spine, a surgeon would have to make incisions (cuts) in or near those areas. This is the case for traditional surgery in those areas, and traditional brain surgery may also require temporary removal of part of the skull and layers of protective tissue (a craniotomy).
With endovascular neurosurgery, however, the surgeon makes a small incision to access an artery, usually in the groin but sometimes in the wrist. Then, a small tube called a catheter is advanced under x-ray guidance to the target blood vessel in the brain or spine.
This procedure is sometimes known as interventional neuroradiology (INR) and endovascular surgical neuroradiology (ESNR). The “radiology” part of the name refers to the X-rays or other imaging techniques used to guide the catheter and view the area as the procedure is performed.
Conditions Treated with Endovascular Neurosurgery
There are several conditions for which endovascular neurosurgery is an option, including:
- Arteriovenous malformations (AVMs): This is when blood vessels become tangled and cause multiple irregular connections between arteries and veins.
- Aneurysms: An artery can become weak enough to bulge (putting pressure on surrounding tissues) or burst (causing internal bleeding).
- Carotid stenosis: This is a narrowing of one or both of either of the major blood vessels supplying blood to your brain and other areas in your head.
- Stroke: This common brain condition occurs when there is an interruption of the blood supply to the brain. This can be caused by a clot (which blocks blood flow) or rupture (which causes the blood to go elsewhere) in a vital vessel. A stroke can cause brain cells to die within minutes.
- Tumors: Endovascular techniques can be used to reduce blood flow to a tumor prior to surgical removal, making surgery safer by reducing blood loss..
Types of Endovascular Neurosurgery Procedures
Endovascular neurosurgery describes the method used to access the area that needs treatment, but there are several kinds of procedures that can be performed, depending on your condition, including:
- Cerebral angiography: This is actually a diagnostic procedure rather than a treatment. An angiography is a medical imaging technique that examines the health of blood vessels. This information can be helpful in finding abnormalities or assisting a surgeon before an actual surgery is performed inside the head or neck.
- Carotid angioplasty (stenting): This procedure is used to treat the narrowing of one or both carotid arteries (a condition known as stenosis), which circulates blood to the brain. A tiny balloon is inserted into the narrowed artery, which widens it, and then a wire mesh tube called a stent is placed to keep the artery open.
- Endovascular coiling: This procedure feeds a tiny coil into the bulge of an artery (the aneurysm) and seals it off, so it can no longer fill with blood and burst.
- Thrombolytic therapy: Thrombolytic medicines are designed to quickly dissolve blood clots, a major cause of heart attacks and strokes. These medicines can be administered through endovascular surgery. More often, an attempt is made to re-open a blocked blood vessel in the case of stroke – a procedure called mechanical thrombectomy.
Advantages of Endovascular Neurosurgery over Traditional Surgery
Unlike traditional “open” surgery, endovascular surgery is considered less invasive, which brings advantages including:
- Fewer, smaller incisions (and no incisions in the skull)
- Less damage to parts of your body that would be disturbed while accessing the surgical site
- Quicker recovery time
- Use of local or regional anesthesia (which numbs parts of the body) instead of general anesthesia (which makes the patient unconscious)
- Fewer risks for older patients, or patients with other medical conditions
Are You a Candidate for Endovascular Surgery?
Whether you would qualify as a candidate for endovascular surgery depends on several factors, including your medical history and the specifics regarding your condition. Your surgeon will discuss your options in-depth at your appointment.
Contact M. Neil Woodall, MD, Today
Dr. Woodall has the skill, care, and experience to perform a wide range of endovascular neurosurgery procedures for conditions of the nervous system. Get the treatment you need — without leaving the Athens area. Contact our office today.