Endovascular neurosurgery is an option for many types of cerebrovascular conditions. Because it is minimally invasive, you usually experience less pain, a shorter hospital stay, and faster recovery.
Our multispecialty endovascular neurosurgery team evaluates each new patient and identifies all treatment options. When possible, we recommend an endovascular approach.
What Is Endovascular Neurosurgery?
Endovascular neurosurgery provides treatment from inside your blood vessels using thin tubes, or catheters. Your doctor inserts the catheter into an artery in your groin or wrist through a small incision. Using medical imaging, they guide the catheter to your neck or head and deploy different types of treatments.
Endovascular neurosurgery can effectively:
- Close off abnormal blood vessels
- Open a blockage
- Reinforce a weak area
- Repair a burst or damaged blood vessel
Who Performs Endovascular Neurosurgery?
At Penn, interventional neuroradiologists and cerebrovascular surgeons perform endovascular procedures. They are experts with the catheters and wires used in the treatment of complex cerebrovascular diseases.
Meet our team
Types of Endovascular Neurosurgery Procedures
There is a wide range of endovascular neurosurgical procedures available and new ones are emerging all the time. Our specialists are at the forefront of this advancement. We help bring the latest procedures from development to clinical practice by participating in neurosurgery research and clinical trials. Through clinical trials, you may have early access to new therapies that aren’t widely available elsewhere.
Endovascular neurosurgery procedures we offer include:
Angioplasty
Angioplasty is a procedure to open up a narrowed or blocked blood vessel. It is an effective treatment for carotid artery disease and blockages in other blood vessels in the neck and head.
During angioplasty, your doctor inserts a small, deflated balloon through the catheter to the blocked area. They inflate the balloon to compress the plaque against the wall of the blood vessel and open it up.
Stenting
A stent is a metal mesh hollow tube. Doctors often use a stent in combination with angioplasty to help support the blood vessel and keep it open.
After the angioplasty, the doctor inserts the stent through the catheter in a collapsed state. Once in place, they open the stent and fit it inside the artery.
Endovascular Stroke Treatment
For stroke caused by blood clots, rapid removal of the clot is essential. Every minute your brain goes without oxygen, millions of brain cells die. Using endovascular treatment, we can rapidly access the clot and remove it.
Techniques for clot removal include suction and stent retrieval. In stent retrieval, the doctor inserts a collapsed stent into the clot and expands it. The stent traps the clot. As the doctor pulls the stent out, the clot comes with it.
Embolization
Embolization is the process of blocking off blood flow as a form of treatment. Doctors frequently use embolization to treat brain aneurysms, arteriovenous malformations (AVMs), dural arteriovenous fistulas (DAVFs) and other vascular malformations.
The types of embolization procedures we perform include:
Coiling
Coiling is a common type of embolization procedure for ruptured and unruptured aneurysms. The doctor inserts the catheter into the aneurysm and fills it with soft wire coils to prevent blood from flowing in.
Stent-Assisted Coiling
Coiling alone works well for narrow aneurysms. But sometimes, aneurysms are wider and there is nothing to hold the coils in place. In this case, the doctor inserts a stent into the artery to provide support before inserting the coils.
Balloon-assisted Coiling
Balloon-assisted coiling is another technique for treating wider aneurysms. The doctor inflates a balloon inside the artery to create a neck and then inserts the coils. Once the coils are in place, they deflate and remove the balloon.
Intrasacular devices
Intrasacular devices are newer devices for treating aneurysms. They look like small metal baskets. The doctor expands the device inside the aneurysm, where it blocks flow and prevents rupture.
Flow Diversion
Flow diverters are similar to stents but have tighter mesh walls. They fit securely inside the blood vessel and cut off blood flow to the aneurysm. Eventually, the lining of the blood vessel grows across the stent, sealing the aneurysm off from the artery.
Liquid Embolization
In AVMs and DAVFs, the arteries and veins are abnormally connected. This creates high pressure in the receiving veins, which can rupture and cause a dangerous stroke.
The main form of treatment for these conditions is to plug the malformation to prevent blood from flowing into it. Our doctors insert glue or other liquid agents that congeal inside the blood vessels. Often, they combine liquid embolization with surgery. The embolization blocks off the malformation so the surgeon can remove it more safely.
Percutaneous Sclerotherapy and Cryotherapy
For venous and lymphatic malformations that occur on the face, head or neck, we may inject substances to shrink them. The term percutaneous means “through the skin.”
In sclerotherapy, the doctor injects an irritating agent into the vein or lymph vessel. This causes scarring and eventual shrinkage of the malformation. Cryotherapy uses cold liquid to freeze the area and promote shrinkage.
Endovascular Neurosurgery: The Penn Medicine Difference
Given the complexity of cerebrovascular diseases, you want the most experienced team and advanced care possible. At Penn, we offer:
- Deep expertise: Our interventional neuroradiologists and cerebrovascular surgeons perform thousands of endovascular procedures each year. We are a magnet hospital for patients from other hospitals who require higher-level care.
- Coordinated team: Teamwork is a key element of our work. Our diverse team of doctors, advanced practice providers, nurses and support staff ensure all aspects of your care are covered.
- State-of-the-art facilities: Penn’s new hospital, the Pavilion, features operating rooms equipped with the latest endovascular equipment. For example, our biplane angiography unit provides advanced imaging and guidance during endovascular neurosurgery.
- Clinical trials: We have a robust neurosurgery research program. Clinical trials are establishing new treatment modalities and providing better outcomes for patients with cerebrovascular diseases.
Request an Appointment
To make an appointment, please call 800-789-7366 or request a callback.