Neuro-interventional Radiology is a subspeciality in which radiologists perform minimally invasive, image-guided procedures to locate and treat conditions of the central nervous system.
The minimally invasive treatment of acute stroke and brain aneurysms are two examples of neuro-intervention that are likely to become increasingly important in healthcare. These highly specialised procedures can be potentially life-saving and are currently performed at SCP.
Mechanical thrombectomy
In acute ischemic stroke (where a clot forms in a blood vessel and prevents blood and oxygen from reaching parts of the brain), mechanical thrombectomy is used to remove the clot and to restore blood flow.
It is often used in addition to thrombolysis (using medication to dissolve the clot) as an emergency treatment for acute stroke and, depending on the scenario, could significantly improve outcomes for the patient.
It is very important to try and improve the blood flow to the brain as soon as possible to prevent additional damage to the brain and to improve the outcome.
Patients should therefore go to their closest emergency department where they can be diagnosed.
Emergency imaging is performed and if mechanical thrombectomy is indicated, the patient can be transferred to the angiography suite where thrombectomy can be performed.
During the procedure, a thin plastic tube called a catheter is inserted into a blood vessel and then carefully threaded to the location of the clot. The vascular access is usually from the groin. The procedure is performed under sedation and local aneasthetic or general aneasthetic.
Once the catheter is guided to the right area, a liquid contrast material is injected through the catheter and X-rays are used to produce superb images of the blood vessels.
Once the precise location of the clot has been identified, a retrieving device will be used to extract the clot, to restore blood flow and potentially limit the damage caused by the stroke.
The medical team will work as speedily as possible but, depending on the circumstances, the procedure may take up to two hours to perform.
The patient will be taken to ICU for supportive care and stroke management by the clinical team.
Cerebral aneurysm treatment
A cerebral or brain aneurysm is a small, balloon-like bulge that forms at a weak spot in a blood vessel in the brain. Some aneurysms pose a risk of rupturing which, in turn, can easily cause the patient’s death or catastrophic cerebral damage.
Specialists in neuro-interventional radiology can use minimally invasive endovascular treatment to prevent cerebral aneurysms from rupturing, and 90% of aneurysms can be successfully treated in this way. Ruptured aneurysms can also be treated to prevent rebleeding.
Not all aneurysms need to be treated and advice can be given regarding rupture risk and indications for treatment.
As with any other invasive procedure, the intervention isn’t free of risk and therefore the risk of every individual patient and aneurysm is considered before deciding on the treatment .
- As the procedure is performed under general anaesthetic, you will be required not to eat or drink anything for up to eight hours prior to your procedure.
- Inform us of all existing medical conditions and medication that you may be taking.
- Inform us of allergies, especially to iodine or contrast material.
- A blood sample may be drawn to confirm whether your kidneys are working normally and that your blood will clot normally.
- You will be requested to remove your clothing and to wear a gown during the procedure.
- You may be asked to remove jewellery, spectacles and any metal objects that might interfere with the X-ray images.
During the procedure, a thin plastic tube called a catheter is inserted into a blood vessel and then carefully threaded to the location of the aneurysm. Access to the artery is in the groin(femoral) or wrist (radial).
Once the catheter is guided to the right area, a liquid contrast material is injected through the catheter and X-rays are used to produce superb images of the blood vessels.
Once the precise location of the aneurysm has been identified, a micro-catheter is meticulously placed into the aneurysm. This is then used to guide several platinum coils into the aneurysm, where they will block further blood flow into the aneurysm, thus preventing possible rupturing.
Occasionally a stent or balloon may be used to ensure correct positioning of the coils in the aneurysm.
Depending on the circumstances, the procedure typically lasts between two to three hours.
You will be taken to ICU and then closely monitored for possible complications.
With treatment of unruptured aneurysms you may be able to go home the following day.
Other neuro-interventional procedures
Other procedures in neuro-interventional radiology that are performed at SCP Radiology, include the following:
Treatment and guidance on arteriovenous malformations (AVM)
A condition in which arteries and veins connect irregularly, disrupting normal directional blood and oxygen flow. Pressure in these malformations weaken the blood vessels over time and may cause them to rupture.
Pre-surgical tumour embolisation
A procedure in which blood supply to a tumour is decreased in preparation for surgical removal.
Epistaxis embolisation
A procedure in which blood supply to the nasal region is decreased to treat life-threatening nose bleads.
Inferior petrosal sinus sampling
A test to diagnose the cause of hormonal disorders by sampling blood from veins at the base of the skull which drain blood from the pituitary gland.
Transverse sinus stenting for benign intracranial hypertension or pulsatile tinnitis
This involves the placing of a stent in a narrowed segment of a vein at the back of the head to improve outflow.
Available at: SCP Radiology Cape Gate
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Enquire here about the cost of a procedure and if funded by a medical aid, the extent of cover provided.
SCP’s services are offered at medical aid rates.