Neurointerventional Surgery: What to Expect Before, During and After Your Procedure

That usually isn’t what happens. Neurointerventional surgery treats conditions of the brain, neck and spine from inside the blood vessels. The skull isn’t opened. A specialist guides a thin, flexible tube called a catheter through an artery in your wrist or groin to reach the problem area. Most patients go home within a day or two, and many go home the same day.

What Is Neurointerventional Surgery?

Neurointerventional surgery is a minimally invasive way to diagnose and treat blood vessel problems in the brain and spine. As the doctor moves the catheter, they watch live X-ray images on a screen, so they can see where it is the whole time.

You may also hear it called interventional neuroradiology, neurointerventional radiology, endovascular neurosurgery or neuroendovascular surgery. All of these names refer to the same field. The doctor who performs these procedures is often called a neurointerventionalist. Learn more about Neuroscience Group’s neurointerventional radiology services.

Conditions Neurointerventional Surgery Can Treat

Neurointerventional specialists treat a wide range of conditions, including:

• Ischemic stroke, using a mechanical thrombectomy to remove the clot that’s blocking blood flow
• Brain aneurysms, using coils, a flow-diverting stent such as the Pipeline device, or the WEB device to seal off the weak spot
• Narrowed arteries in the brain or neck, using stents to open them back up
• Arteriovenous malformations (AVMs) and other abnormal vessels, using embolization to block them off
• Idiopathic intracranial hypertension, using venous sinus stenting to relieve pressure around the brain
• Spinal compression fractures, using kyphoplasty or sacroplasty to stabilize the bone

Cerebral angiogram is a diagnostic test that uses the same catheter technique to map the brain’s blood vessels in detail, which gives your care team a clear picture before they recommend treatment. See the full list of Neuroscience Group’s endovascular services.

Before Your Procedure

Planned procedures usually start with imaging and are completed in a hospital setting. An MRI, CT scan or cerebral angiogram shows your doctor which blood vessels are involved and helps them choose the right approach. Neuroscience Group offers imaging and neurodiagnostic services to support this step.

At your pre-procedure visit, your care team will go over:

• Every medication you take, especially blood thinners, which you may need to pause or adjust
• Any allergies, particularly to contrast dye or iodine
• Bloodwork to check your kidney function, since your kidneys filter the contrast dye
• When to stop eating and drinking the night before

Plan for someone to drive you home. Sedation can affect your judgment and reaction time for the rest of the day.

Stroke treatment is the exception. A thrombectomy is an emergency procedure, often done within hours of symptoms starting, so there’s no prep visit. If you notice sudden weakness, facial drooping or trouble speaking, call 911.

During Your Procedure

Depending on the procedure, you’ll get either sedation or general anesthesia. Sedation keeps you relaxed and comfortable while you stay awake, and general anesthesia puts you fully to sleep. Diagnostic angiograms are often done with sedation. Longer treatments, like aneurysm repair, usually use general anesthesia.

The doctor numbs a small area on your wrist or groin and makes a tiny puncture in the artery. You won’t have a large incision or stitches in your scalp. The doctor then guides the catheter through your blood vessels to the treatment area while contrast dye makes the vessels visible on screen. Some patients feel a brief warm sensation when the dye goes in. It passes in a few seconds.

A diagnostic cerebral angiogram usually takes about an hour. Treatment procedures can take two hours or more, depending on what’s being repaired.

After Your Procedure: Recovery and Follow-Up

Right after the procedure, you’ll rest while a nurse checks the access site. If the catheter went in through your groin, you’ll lie flat for a few hours so the artery can seal. With wrist access, you can usually sit up and move around sooner.

Patients who have a diagnostic angiogram often go home the same day. After a treatment procedure, you may stay in the hospital overnight so your team can monitor you.

Mild side effects are common and usually fade within a few days:

• Bruising or soreness where the catheter was inserted
• A mild headache
• Feeling tired for a day or two

Call your care team if you notice bleeding, swelling or numbness at the access site. Call 911 right away for sudden weakness, vision changes, confusion or trouble speaking.

Most people are back to normal activities within a few days to a week. You’ll need to skip heavy lifting and hard exercise for a while, and your doctor will tell you how long. Many patients come back for follow-up imaging at an office visit to confirm the treatment worked.

Neurointerventional Care at Neuroscience Group

Neuroscience Group’s neurointerventional team sees patients at our Neenah clinic. Our neurologists and neurosurgeons work alongside the imaging team, so your providers can share results and plan next steps together. You won’t be sent from office to office to get answers.

If you have questions about a procedure your doctor recommended, or you want to talk through your options, request an appointment or call 920-725-9373.