New Ways to Stop a Stroke in Progress
New treatments for a stroke can be effective in limiting, or even reversing, damage from stroke.
A growing subspecialty called Interventional Neuroradiology provides new ways to treat brain disorders and emergencies on a minimally invasive basis, from within the blood vessels of the brain, guided in real time by three-dimensional imaging.
- Carotid stenting:
The carotid arteries, which carry oxygen and nutrients to your brain, can be blocked by fatty plaque and blood clots. For some people, a surgical procedure called carotid endarterectomy works well to open them. But this surgery can be too risky for people with certain risk factors. Now there is an option called carotid stenting with distal protection.The interventional neuroradiologist reaches the carotid through a catheter advanced through the body’s vascular system.The distal protection
is a small filter that is placed “downstream” from the area of narrowing to catch any bit of plaque that might break off during the procedure. After using angioplasty to widen the narrowing, the interventional neuroradiologist slips a tiny mesh stent into the site and deploys it. The stent keeps the carotid from closing up again, and has proven to be
a safer treatment than surgery for the patients with certain risk factors. It was approved by the FDA late in 2004.
- Clot retrieving
A blood clot in the brain is a medical emergency. Depending on how much brain tissue is deprived of circulation, it can cause disability or death. One standard treatment is an intravenous tPA “clotbuster” medication. But many stroke patients come to the hospital too late to receive tPA, and not all patients can take it safely.
Now Mission offers the newest treatment for clots in the large vessels of the brain – a miniature corkscrew called the MERCI retrieval device. Guided by high tech imagery, the MERCI device is advanced through the blood vessels into the clot and gently pulled out. For some patients, most stroke symptoms are immediately reversed.
- Coiling to treat brain aneurysms
A lifesaving interventional neuroradiology procedure offered at Mission for years is “coiling” for the treatment of dangerous brain aneurysms.This uses a tiny platinum device that interventional neuroradiologists slip into the bulge of an aneurysm, where it stimulates the body to fill and seal off the aneurysm.The coil can be placed before an aneurysm has begun to leak, or after a hemorrhagic stroke has already begun.
Mission interventional neuroradiologists work closely with Mission neurosurgeons and neurologists to evaluate the patient’s need and determine what treatment is best. Mission’s interventional neuroradiology program is staffed by three fellowship trained interventional neuroradiologists, Jonas Goldstein, M.D.,William Marx, M.D., and John Short, M.D., and is available around the clock.
For information or referral call 828-213-1395.
