In addition, neuro-endovascular therapy is used for pre-surgical embolization for spinal, intracranial, and head and neck vascular tumors in functional testing including petrosal sinus sampling, temporary balloon occlusion testing and superselective WADA tests.
Why are patients under the joint care of an interventional radiologist and a neurosurgeon?
Neuro-endovascular therapy requires the expertise of both the interventional radiologist and neurosurgeon. In fact, many patients requiring endovascular therapy are best treated using a combination of minimally invasive and surgical procedures. Neuro-endovascular treatment planning is accomplished using an interdisciplinary approach to maximize patient outcomes and minimize patient risks. In this environment, patients benefit from the clinical expertise of the neurosurgeon and the radiologist's expertise in image-guided techniques.
What is the pre-procedure evaluation?
Interventional neuroradiologist Christopher Baker, M.D. , sees patients for consultation at Maine Neurosurgery's office in Scarborough, Maine, six miles south of Portland. During the evaluation, patients and/or their families are fully informed about the risks and benefits of the procedure, as well as about expected results. Dr. Baker can arrange for additional consultation by other specialists if needed.
How is the procedure performed?
Procedures are performed in a state-of-the-art neuro-endovascular bi-plane angio suite at Maine Medical Center. Depending on the procedure, patients receive either general anesthesia or conscious sedation. In general, the procedure takes 3-6 hours. Microcatheters are used to navigate from the femoral artery or vein to the abnormal target vessels which are treated with balloons, platinum coils, liquid adhesive, particulate emboli, or stents, depending on the type of lesions.
What are the results?
Because neuro-endovascular therapy is minimally invasive, patient recovery time is shorter than after surgery. In addition, the results are at least comparable and, in many instances, are superior to conventional surgery.
What is the post-procedural care?
Patients are generally in the hospital for 2-3 days following the procedure. After the procedure, patients are transferred to either the Post Anesthesia Recovery Unit or Special Care Unit. Once patients are stabilized, they are moved to the Stepdown Unit. During this time, patients continue to be jointly managed by the interventional radiologist and attending neurosurgeon.
In general, patients will be seen four weeks after the procedure for a follow-up visit. Patients may require an MRI, MRA, or cerebral angiogram which may be scheduled locally or in Portland.