Spartanburg Radiological Associates



Intra-Cranial Thrombolysis for Stroke Intervention

Acute ischemic stroke is a life threatening medical emergency. It is the leading cause of disability and the third leading cause of death in the United States. Ischemic stroke is the result of interrupted blood flow to the brain, usually from a clot that has traveled from another part of the body. They are associated with a neurological deficit that may
transient or permanent.

Symptoms of stroke may be variable depending upon the part of the brain that is affected. They may include change in mental status, weakness or loss of function in extremities or facial muscles, visual disturbances, difficulty or inability to speak or comprehend. Once symptoms are recognized it is imperative that you seek medical attention immediately. An ischemic stroke in progress often can be reversed with the use of “clot busting”medications. The drug may be administered intravenously or intra-arterially. Highly trained physicians called Neuro-Interventional Radiologists, insert tiny catheters into the affected artery and deliver medication directly into the clot. These medications “dissolve” the clot and restore blood flow to brain tissue.

Treatment may be beneficial despite extent of neurological deficit. Typically, with intravenous thrombolytics the “window of opportunity” is three hours. With intra-arterial infusion, treatment may be initiated up to six hours after onset of symptoms. However, length of time from onset of symptoms to initiation of treatment is crucial to obtain the best possible outcome.

Embolization of Cerebral Aneurysms

Aneurysms are weakened areas of a vessel wall. It is unclear why they occur and their incidence tends to increase with age. They can occur in any vessel, but primarily affect the large arteries in the body. They may also affect blood vessels in the brain.

Cerebral aneurysms are not uncommon and may affect as much as 5% of the population over the age of 65. Untreated, the aneurysm may rupture resulting in a subarachnoid hemorrhage, or bleeding in the brain. Mortality is high. It is estimated that 10% of patients with ruptured aneurysms die before reaching the hospital, 50% eventually die from complications associated with the bleed and 25% suffer permanent neurological deficits (Putnam et. al).

Cerebral aneurysms have historically been treated with open surgery. This requires the physician, a neurosurgeon, to open part of the skull and identify the aneurysm. Then, a clip is placed to occlude blood flow into the affected part of the artery. This is a very effective treatment method but is highly invasive.

Endovascular treatment with coil embolization is another very effective treatment option that is minimally invasive. A Neuro-Interventional Radiologist inserts a very small catheter into the artery in the groin. The catheter is advanced into the aneurysm. Minute particles are then packed into the aneurysm to occlude blood flow and prevent rupture of the aneurysm or prevent repeat bleeding if rupture as already occurred. Coiling is less invasive and requires much less recovery time.