Diseases and conditions

Stroke

What is stroke?

A stroke occurs when blood flow to the brain is interrupted, reduced or cut off. Within minutes of a stroke, brain cells begin to die and cause the person to experience sudden symptoms, including numbness/tingling, vision changes, trouble speaking and/or confusion. A stroke is a medical emergency, and prompt treatment is critical. If acted upon early, brain damage can be minimized.

There are three major types of stroke: ischemic, hemorrhagic, and transient ischemic attack (TIA).

  • Ischemic: The most common type, an ischemic stroke, occurs when the flow of blood is blocked by a clot or other obstruction.
  • Hemorrhagic: When a blood vessel in the brain bursts, it disrupts blood flow and results in a hemorrhagic stroke. These can be caused by severe high blood pressure or the bursting of an aneurysm (ballooning of the artery wall).
  • Transient ischemic attack: A TIA, also known as a mini-stroke, occurs when a person only experiences stroke symptoms for a short period of time, with the symptoms disappearing within a day. TIAs may be a sign of future stroke and should be brought to your health care provider’s attention.

Treatment

Interventional radiologists are board-certified physicians who can treat strokes by delivering minimally invasive treatments with less risk, less pain and less recovery time than traditional surgery.

Catheter-directed thrombolytic therapy

Board-certified interventional radiologists can use catheter-directed thrombolytic therapy to restore blood flow to the part of the brain that is not receiving blood due to blockage caused by a blood clot. Through a tiny incision in the skin to access the femoral artery and through the use of live, x-ray -guided imagery, the interventional radiologist directs a catheter (a thin plastic tube) through the body's blood vessels to the clot located in the brain. Once at the clot, the physician delivers the thrombolytic agent, in a targeted manner, directly at the clot to dissolve it, restoring the opening of the blood vessel.

Carotid artery angioplasty and stenting

Interventional radiologists use carotid artery angioplasty and stenting to clear a blockage that is preventing sufficient blood flow to the brain. For example, the build-up of plaque within arteries (atherosclerosis) causes a section of blood vessel to become narrower than normal, decreasing blood flow to the brain. The most common site of atherosclerosis is the carotid arteries in the neck. With carotid artery angioplasty and stenting, interventional radiologists guide a catheter with a tiny balloon tip through the blood vessels into the blockage. They inflate the balloon to widen the artery, which restores blood flow, then place a stent in the artery to help keep it open.

Endovascular coil treatment

For aneurysms that can lead to hemorrhagic stroke, interventional radiologists can perform a treatment called endovascular coil treatment (ECT). Preparation for ECT involves finding the aneurysm and determining characteristics such as its position, shape, and size. Tests or scans used during this preparation process include CT, MRI, and angiogram. With this information in-hand, interventional radiologists make a tiny incision in the skin to place a catheter in a large blood vessel in the groin. They then guide the catheter to the aneurysm and place a coil at the site of the aneurysm. For bigger aneurysms, multiple coils may be used. These coils induce clotting of the aneurysm, which will decrease the likelihood of the aneurysm bursting and causing a stroke.

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