Cerebrovascular Surgery

Cerebrovascular disorder treatment

Surgery for cerebrovascular disorders includes:

Cerebral (brain) aneurysm surgery

A cerebral aneurysm is a bulging, weakened area in the wall of an artery in the brain. The bulging creates an increased risk for rupture (bursting) of the aneurysm. Surgical procedures to repair cerebral aneurysms include:

• Open craniotomy (brain surgery), or surgical clipping: A neurosurgeon makes an incision in the scalp and skull in order to place a clip across the aneurysm to prevent blood from flowing into it.
• Endovascular coiling, or coil embolization: Our neuro-interventional radiologists have a high level of expertise in this minimally invasive technique. Coiling requires no incision. A neuro-interventional radiologist guides a thin tube (catheter) through a blood vessel from the groin into the brain. Using fluoroscopy (live video X-ray), we guide the catheter into the aneurysm and place tiny platinum coils inside it. The coils mold to the shape of the aneurysm, causing it to clot (embolization).

Surgery for cerebral arteriovenous malformation (AVM)

AVMs occur when a group of blood vessels forms incorrectly, putting them at risk for rupture. Surgical procedures to repair AVMs usually involve a combination approach (multimodality) including:

• Endovascular embolization: During this minimally invasive procedure, our neuro-interventional radiologists guide a catheter through the blood vessels from the groin to the brain. They use fluoroscopy to guide it precisely. They then inject a glue-like substance through the catheter into the AVM, reducing the blood flow to prevent rupture.
• Open craniotomy (brain surgery): A neurosurgeon removes part of the skull to expose and remove the AVM.
• Gamma Knife® Icon™ radiosurgery: Our surgeons are part of a team that deliver focused radiation beams to specific locations in the brain. The radiation creates scar tissue in the AVM, and the AVM shrinks. Learn more about Gamma Knife Icon radiosurgery.

Stroke treatment

A stroke occurs when blood flow to the brain is disrupted. This happens when a blood clot blocks a blood vessel or a blood vessel in the brain bursts.

At LVHN, we treat the highest number of stroke patients in the region using Stroke Alert. Stroke Alert is a rapid process that involves:

• First responders who bring patients to our Comprehensive Stroke Center
• Our team of emergency and neurology specialists who use early testing and prompt evaluation to get patients rapid, effective care

Stroke treatments are performed by fellowship-trained neuro-interventional radiologists. Treatments include:

• Thrombolysis: We use intravenous (IV) medications, including the clot-buster tPA, to break down blood clots.
• Intra-arterial stroke therapy: This treatment is only available in advanced comprehensive stroke centers like LVHN. We thread a micro-catheter – a tiny, flexible tube – directly into the brain to precisely deliver tPA.
• Clot retrieval devices: We are leaders in procedures that guide a device through the arteries, starting in the groin and advancing to the brain. We then either pull or suction the clot out.
• Cerebral angioplasty: We insert a catheter into the blood vessel that needs treatment. We then inflate a balloon at the end of the catheter. The balloon opens the narrow part of the blood vessel and improves blood flow.