Head and Neck Services
Interventional Neuroradiology {also known as Neurointerventional Surgery or Endovascular Neurosurgery} is a sub-specialty that performs minimally invasive procedures to diagnose and treat diseases of the brain, head, neck, and spine. Neurointerventional procedures use state-of-the-art devices and image-guided techniques to deliver treatments through a small puncture in the skin of the groin or arm instead of open surgery.
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Sclerosing Injections
Sclerotherapy is a procedure used to treat blood vessels or blood vessel malformations and also those of the lymphatic system (venolymphatic malformations). A sclerosant medication is injected into the abnormal vessels, which is intended to produce an inflammatory/fibrotic reaction that allows the vascular channels of the venolymphatic malformation close. This abnormal vascular lesions usually present in children and young adults.
Epistaxis Embolizations
Nose bleeding (or epistaxis) is a not uncommonmedical condition that can occasionally become serious when it is refractory to conservative medical treatments. When conservativemaneuvers, including anterior and posterior packing of the nasal cavity, are unsuccessful at controlling the bleeding, interruption of the blood supply to the sinonasal area can be performed, either by surgical ligation or by transarterial embolization. The procedure involves diagnostic angiography with meticulous attention to the collateral pathways between the extra-cranial, orbital, and intra-cranial circulation followed by the injection of small particles through microcatheter into the tiny arteries that supply blood flow to the back of the nose.
Head and Neck Tumor Embolizations
Tumor embolization is a nonsurgical, minimally invasive procedure performed by interventional radiologists andinterventionalneuroradiologists. It involves the selective occlusion of blood vessels by purposely introducing emboli, in other words deliberately blocking a blood vessel. In the setting of tumors of the head and neck, embolization can be performed preoperatively to reduce the amount of bleeding that may occur during surgery. Highly vascular tumors, such as glomus tumors, paragangliomas, meningiomas, and metastatic renal/lung/breast/melanoma/renal cell carcinomas are a few examples of tumors that are amenable to preoperative embolization.
Vessel Sacrifice for Angioinvasive tumors & infections
There are aggressively behaving tumors and infections and even post-traumatic and post-surgical situations that may occur that may result in exsanguination if not treated by the deliberate sacrifice or occlusion of the at risk blood vessel. Because the cerebral circulation has built in redundancies (or connections) between the front and back and right and left, such deliberate sacrifice may result in no long term negative consequence for the patient. The parent artery sacrifice procedure involves the deliberate occlusion of one of the carotid or vertebral arteries by deployment of numerous coils and/or vascular plugs into the blood vessel lumen until complete obstruction of flow is achieved.