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Neurointerventional Surgery

Minimally invasive brain surgery for cerebrovascular disorders

A doctor points to a computer screen while talking with her patient, representing the high-tech approach to neurointerventional surgery at Scripps.

Minimally invasive brain surgery for cerebrovascular disorders

Neurological problems involving the blood vessels in your head, neck and spine, such as stroke or aneurysm, are known as cerebrovascular conditions and used to require open brain surgery. Scripps neurosurgeons now diagnose and treat many of these conditions using minimally invasive techniques, including neurointerventional surgery.


Neurointerventional surgery uses an angiogram — an imaging technique that measures blood flow in the brain — to diagnose and treat cerebrovascular conditions. Neurointerventional procedures are a form of endovascular surgery, during which the surgeon inserts tiny tubes known as microcatheters into the large artery near the groin. The catheter is then guided through the body into the vessels that lead to the brain. Neurointerventional surgeons can use these microcatheters combined with angiography to simultaneously identify, diagnose and treat a cerebrovascular condition.


Given the complex nature of brain disorders and conditions, our interventional neuroradiologists often collaborate with specialists in neurology and neurosurgery. Our team approach ensures that our patients receive comprehensive, personalized treatment plans based on the latest in neuroscience.

Benefits of neurointerventional procedures

Neurointerventional techniques may offer several benefits over open surgery. These procedures are minimally invasive, which means fewer and smaller incisions. As a result, patients generally have reduced pain and scarring, fewer risks for complications, and faster healing times.


In addition, because neurointerventional surgery can go directly to the affected area, it can increase the window of time needed to safely treat an ischemic stroke from three to eight hours.

Brain procedures

Neurointerventional procedures for brain conditions include:

Intra-arterial infusion of thrombolytics

Thrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks and stroke, and is used to treat ischemic strokes. In this procedure, the surgeon guides a microcatheter to the blood clot, releases clot-busting medication directly into the clot and then physically removes the clot using a mechanical retrieval device. 

Angioplasty and stenting of the carotid, vertebral and intracranial arteries

During an angioplasty procedure, the surgeon uses microcatheters to place a stent inside a blocked artery to hold it open and allow blood to flow properly.

Embolization

An embolization is a minimally invasive procedure that selectively occludes blood vessels or abnormal vascular channels. Medications or synthetic materials are placed through a catheter to prevent blood from flowing through it. This procedure can be used to treat tumors, arteriovenous malformations (AVM), arteriovenous fistulas (AVF), aneurysms and bleeding from traumatic injury or disease. Embolization may be performed through direct puncture of a vascular or lymphatic lesion with a sclerosing or embolic agent. 

Vasodilator infusion

This procedure infuses medication directly into a spasming blood vessel (called vasospasm) to prevent the blood vessel from collapsing.

Spine procedures

Neurointerventional surgery is also used in spinal procedures, including:

Percutaneous vertebroplasty

A neurointerventional surgeon uses a needle to inject bone cement into the spine to treat compression fractures of the spine, often caused by osteoporosis, trauma or spinal tumors.

Kyphoplasty

Similar to vertebroplasty, kyphoplasty uses a small balloon in the interior of the vertebra to push apart the fractured area and restore it to its natural shape before inserting bone cement.

Minimally invasive lumbar decompression (MILD)

This procedure uses a small incision to remove portions of the tissue around the spine that causes a compression of the nerves known as spinal stenosis.

Locations

Scripps Health offers neurointerventional surgery at the following locations in San Diego County: