NEUROSURGERY ARTICLES

WHAT IS ENDOVASCULAR NEUROSURGERY?

by Chiedozie Nwagwu, M.D.

Endovascular Neurosurgery or interventional neuroradiology, as a specialty, has undergone rapid evolution during its short existence. Originally developed in the 1980's by neurological surgeons and radiologists, endovascular neurosurgery is made possible by dramatic advances in computer technology and state-of-the-art equipment. Essentially, endovascular neurosurgery therapies are accomplished through microcatheters inserted in the groin area and, under X-ray guidance, threaded through the blood vessels leading into the brain or spinal cord. Endovascular neurosurgeons currently employ minimally invasive procedures to accomplish a wide variety of treatments including stroke therapy by delivering clot-busting drugs directly to the site of blood vessel blockage. Aneurysm therapy is accomplished by inserting platinum coils into the aneurysm bulge to promote clotting and prevent rupture. Spinal compression fractures are treated by injecting acrylic directly into the bone.

How did Endovascular Neurosurgery Develop?

Traditionally a consulting service, radiology as a medical specialty, developed after the discovery of X-rays. X-rays allowed physicians to create images of internal anatomy of the body without surgery. Today, tens of thousands of radiologists are regularly consulted to perform diagnostic procedures that are foundational to the medical practice of most all physicians in every specialty. While physical examination is the first step in the evaluation of any patient, the best examination skills cannot match the precision and accuracy of modern medical imaging in the diagnosis and characterization of anatomical abnormalities or disease processes.

Endovascular Neurosurgery is a subspecialty discipline of both neurosurgery and radiology. Initially, neurosurgeons performed surgical procedures with the operating microscope. Neurosurgeons can now perform minimally invasive techniques utilizing x-ray fluoroscopy ("real-time" x-ray technology to monitor movement inside the body) and angiography (injection of x-ray contrast or "dye" to obtain pictures of blood vessel anatomy). In addition, physicians have added ultrasound, computed tomography (CT), and even magnetic resonance imaging (MRI) to their arsenals. Such advanced technology allows physicians to visualize operative procedures without making a skin incision to see inside the body.

How Can An Endovascular Neurosurgeon Help Me?

Today, approximately 300 endovascular neurosurgeons, interventional neuroradiologists, and interventional neurologists offer a wide variety of minimally invasive procedures to treat everything from stroke to spinal compression fractures.

As compared to conventional neurosurgery, endovascular treatments often involve less risk and result in less pain and faster recovery period.

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