Endovascular neurosurgery, also known as neurointerventional surgery or interventional neuroradiology, is a specialised field within neurosurgery that focuses on using minimally invasive techniques to diagnose and treat conditions affecting the blood vessels of the brain and spinal cord. This field has evolved significantly with the advancement of imaging technology and catheter-based interventions. Here are some of the key services and procedures associated with endovascular neurosurgery:

• Diagnostic Angiography:
  • Purpose: To visualise blood vessels in the brain and spinal cord.
  • Procedure: A catheter is threaded through the blood vessels from a distant site (usually the femoral artery in the groyne) to the vessels in the brain. Contrast dye is injected to make the blood vessels visible on X-ray.
• Cerebral Angioplasty and Stenting:
  • Purpose: To treat narrowing or blockage of blood vessels (stenosis).
  • Procedure: A balloon-tipped catheter is used to widen the narrowed vessel, and a stent may be placed to keep the vessel open.
• Embolization:
  • Purpose: To block or reduce blood flow to abnormal blood vessels or tumours.
  • Procedure: Small particles or coils are injected through a catheter to block the blood vessels feeding the abnormality.
• Coiling for Aneurysms:
  • Purpose: To treat cerebral aneurysms and prevent rupture.
  • Procedure: Platinum coils are inserted into the aneurysm through a catheter, promoting blood clotting and reducing the risk of rupture.
• Thrombectomy:
  • Purpose: To remove blood clots from vessels, often in the context of acute stroke treatment.
  • Procedure: A catheter is used to physically remove or break down the clot, restoring blood flow.
• Intracranial and Extracranial Stenting:
  • Purpose: To treat stenosis or narrowing of blood vessels inside or outside the skull.
  • Procedure: Similar to coronary artery stenting, a stent is placed to keep the blood vessel open.
• AVM (Arteriovenous Malformation) Embolization:
  • Purpose: To treat abnormal tangles of blood vessels in the brain.
  • Procedure: Embolic agents are injected to block blood flow within the AVM.
• Flow Diversion for Aneurysms:
  • Purpose: To redirect blood flow away from an aneurysm.
  • Procedure: A mesh-like stent is deployed across the neck of the aneurysm, diverting blood flow and promoting healing.
• Vertebroplasty and Kyphoplasty:
  • Purpose: To treat vertebral compression fractures.
  • Procedure: Bone cement is injected into the fractured vertebra to stabilise and alleviate pain.
• Intravascular Ultrasound (IVUS):
  • Purpose: To obtain detailed images of blood vessels from within.
  • Procedure: An ultrasound probe is advanced through a catheter to provide real-time imaging.

Endovascular neurosurgery is often preferred over traditional open surgery for its minimally invasive nature, leading to reduced recovery times, shorter hospital stays, and fewer complications. It plays a crucial role in the comprehensive management of various neurovascular disorders. The specific services provided may vary based on the patient's condition and the expertise of the neurointerventional team.