Endovascular Neurosurgery and Interventional Neuroradiology

If you have a problem that affects your brain or spinal cord, you may be treated by a doctor who focuses on the central nervous system. These doctors can do procedures that are minimally invasive. This means they can be done with a tiny cut (incision). This is often better than a larger incision that is needed for open surgery.

What is endovascular neurosurgery?

Neurosurgery is a type of surgery that treats problems of the brain and nerves. The word endovascular means “inside a blood vessel.” This type of surgery is also known as neurointerventional surgery. It is done with thin tubes (catheters) and small tools. These are put into the blood vessels. This is done instead of surgery with a large cut (incision). The surgeon often uses radiology images at the same time. This is done to help him or her to see the part of the body being treated.

These doctors are trained in both neurosurgery and radiology. Then they do a neurosurgery residency at a hospital. After that, they do a fellowship program in endovascular neurosurgery. A neurosurgeon may be board certified in neurosurgery. This is done through the American Board of Neurological Surgery. There is no board certified specialty for endovascular neurosurgery.

What is interventional neuroradiology?

Radiology is a specialty that helps diagnose and treat conditions with imaging methods. Interventional neuroradiology is a special type of radiology. It uses catheters and imaging to diagnose and treat conditions of the brain and spinal cord. 

These doctors are trained in radiology. And they are trained in neurology or neurosurgery. Then they do a radiology residency at a hospital. After that, they do a fellowship program in interventional neuroradiology. A radiologist may be board certified in neuroradiology. This is done through the American Board of Radiology.

What kinds of procedures are done by these specialists?

The procedures include:

• Thrombolytic therapy. This uses medicine to dissolve a clot in a blood vessel in the brain.

• Blood clot retrieval. This uses a small catheter to remove a blood clot that is blocking the blood flow in a brain artery.

• Endovascular coiling. This is done to treat a brain aneurysm. A brain aneurysm is a bulge in a weak spot in the wall of an artery in the brain. The bulge is at risk of a tear (rupture). This would cause bleeding on the brain. To prevent this, a surgeon puts a very thin metal coil inside the aneurysm. This is done to block blood flow into the bulging area. It may also be closed with a clip.

• Minimally invasive spine surgery. This is done to treat spinal problems. These include fractures, tumors, compressed nerves, and other conditions that put pressure on the spinal cord.

• Cerebral angiography. This is a radiology procedure. It looks at how blood is flowing in the brain.

• Carotid artery angioplasty and stenting. The carotid arteries send blood to the brain. This procedure uses a small balloon to open a carotid artery that has become too narrow. A tiny mesh tube called a stent is then put in place. This keeps the artery open.