Neurological disorders can be complex in nature – but fortunately, their treatment doesn’t have to be. The Valley Hospital’s neurointerventional team offers simplified and effective solutions for these intricate conditions. 

Using minimally invasive techniques and advanced technologies, our neurointerventional specialists offer sophisticated care that can return patients to healthy, active lives sooner. 

The Valley Approach to Neurointerventional Care

At The Valley Hospital, neurointerventional procedures are performed in an advanced neurointerventional suite. For many patients, an interventional procedure can replace extensive neurosurgery, resulting in a shorter hospital stay, quicker recovery time, reduced pain and less risk of complications. Patients continue to receive attentive care after their procedure in Valley’s dedicated Neuro Intensive Care Unit.

Our neurointerventional specialists also recognize that no progress happens without research. In an effort to constantly improve their treatment of patients, they participate in national and international clinical trials for the treatment of acute stroke. 

Conditions Treated

  • Arteriovenous malformation (AVM)
  • Atherosclerosis
  • Benign intracranial hypertension
  • Brain aneurysms
  • Carotid disease
  • Cavernous malformation
  • Cerebral aneurysm
  • Chronic subdural hemorrhage
  • Dural arteriovenous fistula (DAVF)
  • Extracranial tumors
  • Head and neck cancer
  • Intracranial stenosis
  • Intracranial tumors
  • Moya moya disease
  • Nose bleed
  • Pseudotumor cerebri
  • Pulsatile tinnitus
  • Venous stenosis

Neurointerventional Procedures

Diagnostics

A cerebral angiogram is a diagnostic procedure used to detect neurological conditions before neurointerventional treatment is performed. This is done by injecting a special dye into the bloodstream, then taking a specialized X-ray. The iodine dye is a special material known as a contrast agent that will show up on X-rays, providing an image of blood vessels that could not otherwise be seen.

The difference between an angiogram and other imaging tests is that the angiogram provides information on the speed of blood flow and visualizes smaller blood vessels better than other tests do. It is more closely related to a video rather than a photograph. The actual procedure takes approximately 30 minutes. However, the total procedure time, prep and immediate aftercare will take approximately one to three hours.

A brain angiogram is performed on a specialized machine called a biplane fluoroscopy machine.

Traditionally, brain angiograms have been performed through minimally invasive access via the groin artery in the upper thigh, where a small hollow tube is passed through the major artery in the body (aorta) into the neck arteries using arterial mapping and video screens. There, it gets safely positioned and dye gets injected allowing the machine to capture a video of the brain. More recently, a newer and safer approach has been developed utilizing the same system but through the wrist or radial artery which allows for reduced procedure times, faster healing and fewer complications in many patients. 

Interventions

A neurointerventional treatment, also called embolization, is a non-surgical procedure performed to prevent abnormal blood flow to blood vessels or brain aneurysms. Neurointerventions can keep aneurysms from bursting, block blood flow to tumors, and restore normal blood flow. Some types of neurointerventional treatment can treat aneurysms that were once considered inoperable, offering truly lifesaving care.

Types of neurointerventional treatments include:

  • Coiling treatment: Tiny and soft platinum wires are applied to a brain aneurysm to stop it from bleeding.
  • Pipeline or Surpass/Evolve flow diverter treatment: A small wire tube gets deposited into a diseased brain artery and restores it to a normal artery. This device prevents blood from entering from the artery into a blood-filled bubble also called an aneurysm.
  • Woven Endobridge (WEB) Aneurysm treatment: This treatment involves a tiny basket-like device made from ultra-fine wires braided together to form a flexible self-expanding mesh. It is designed to treat challenging aneurysms that often require multiple other treatments. It also avoids the placement of a stent device inside a brain artery. It is associated with a shorter procedure time than alternative therapies, and possibly reduces medications taken after the procedure.
  • Onyx treatment: A lava-like material is used to close off abnormal tangles or connections of blood vessels in the brain such as are seen in a brain AVM (arteriovenous malformation).
  • Tumor embolization
  • Epistaxis embolization

Stenting

Stenting is a minimally invasive non-surgical technique used to open narrowed or blocked blood vessels of the brain. A tiny mesh wire tube, called a stent, is placed to help open the blocked vessel, which restores blood flow through the carotid or vertebral arteries, and ultimately reduces or removes the risk of stroke. Stenting can be performed to treat intracranial stenosis or atherosclerosis, extracranial atherosclerosis, and carotid artery disease. Sometimes, stents are also used in brain aneurysm treatment, where they are used as a scaffold to hold the coils in place inside an aneurysm.

Biplane Angiography System

Valley’s biplane angiography system, housed within a hybrid operating room, is used to diagnose neurological abnormalities by producing highly detailed, three-dimensional views of blood vessels leading to the brain and deep within the brain. It is also used to treat these abnormalities using minimally invasive techniques. 

Valley’s biplane system also produces images simultaneously from two regions of the patient’s head, from front to back and from side to side. This reduces the amount of contrast material required, improves visualization for diagnostic and therapeutic procedures, and shortens the time it takes to complete a neurological angiogram.

If an open procedure becomes necessary, the hybrid operating suite can be easily transformed for open neurosurgical procedures without moving patients and scheduling additional surgery.