Interventional neuroradiology is a subspecialty of radiology and neurology dedicated to the diagnosis and minimally invasive treatment of diseases affecting the blood vessels of the brain, spinal cord, and head using catheter-based techniques. Procedures are performed endovascularly through the vascular system, eliminating the need for open neurosurgical intervention. Access is typically gained via the femoral or radial artery, from which catheters are navigated under fluoroscopic guidance to the target intracranial vessels. The specialty combines expertise in neurology, radiology, and endovascular intervention, requiring an in-depth understanding of cerebral vascular anatomy and the pathophysiology of cerebrovascular disease.
Core Diagnostic Techniques
Cerebral angiography is the gold standard for imaging the cerebral vasculature. Contrast medium is injected directly into the carotid or vertebral arteries under fluoroscopic guidance, producing a detailed map of the intracranial arterial system. It enables accurate identification of aneurysms, arteriovenous malformations (AVMs), arterial stenoses, and vascular occlusions, and is typically the first step before any endovascular intervention.
CT angiography (CTA) and MR angiography (MRA) are non-invasive imaging techniques used for rapid diagnosis and procedural planning. CTA plays a crucial role in the acute assessment of ischemic stroke by rapidly identifying the site of arterial occlusion and evaluating the extent of brain injury. MRA provides more detailed information about vessel wall morphology and surrounding brain tissue without exposing patients to ionizing radiation.
PT and MR perfusion imaging evaluate cerebral blood flow, allowing clinicians to distinguish irreversibly damaged brain tissue from the ischemic penumbra—tissue that is at risk but potentially salvageable. This distinction is essential for determining patient eligibility and the optimal timing for reperfusion therapy.
Key Procedures
Mechanical thrombectomy is an emergency procedure for acute ischemic stroke caused by occlusion of a major cerebral artery. Using either a stent retriever or an aspiration catheter, the thrombus is mechanically removed, restoring blood flow to the affected region of the brain. This procedure has dramatically improved outcomes for patients with large-vessel occlusion stroke and, much like primary PCI in cardiology, requires around-the-clock availability and the shortest possible treatment delay.
Endovascular aneurysm treatment involves advancing a microcatheter into the aneurysm sac and filling it with detachable coils, inducing thrombosis and excluding the aneurysm from the circulation. Wide-neck aneurysms may require adjunctive stent-assisted coiling or the use of flow diverters, which redirect blood flow away from the aneurysm and promote its gradual occlusion. The primary objective is to prevent aneurysm rupture and life-threatening subarachnoid hemorrhage or to secure an aneurysm that has already ruptured.
Embolization of arteriovenous malformations (AVMs) and dural arteriovenous fistulas (DAVFs) involves the injection of embolic agents into abnormal vascular connections to occlude them. The procedure may serve as definitive treatment or as an adjunct before neurosurgery or stereotactic radiosurgery, where reducing blood flow through the lesion lowers procedural risk.
Carotid angioplasty and stenting are performed to treat significant stenosis of the internal carotid artery, a major cause and risk factor for ischemic stroke. A balloon catheter is used to dilate the narrowed segment, followed by stent placement to maintain long-term vessel patency and reduce the risk of future embolic cerebrovascular events.
For Intverventional Neuroradiology, we provide:
- Platinum coils
- Hydrogel-coated platinum coils
- Intrasaccular devices
- Guiding catheters
- Microcatheters
- Balloon catheters for access procedures
- Guidewires
- Intraluminal stents
- Flow diverter stents
- Carotid stents
- Liquid embolic agents
- Mechanical thrombectomy systems
- Aspiration catheters
