Neurointerventions

Neurointerventions, or interventional neuroradiology, is a medical specialty that uses image-guided, catheter-based techniques to diagnose and treat disorders of the brain, spine, and the vessels of the head and neck. The emphasis is on minimally invasive approaches as alternatives to open surgery.

Common procedures include diagnostic cerebral angiography and various therapeutic endovascular treatments. Therapeutic options for intracranial aneurysms include coil embolization and flow-diverting stents. Mechanical thrombectomy is used to remove clots in acute ischemic stroke. Embolization is employed for arteriovenous malformations and fistulas, spinal vascular lesions, and certain tumors. In the spine, embolization can help manage vascular tumors and reduce intraoperative bleeding; vertebral augmentation procedures such as vertebroplasty or kyphoplasty may also be performed in select cases.

Imaging plays a central role, with digital subtraction angiography, magnetic resonance angiography, and computed tomography angiography guiding diagnosis and intervention. Procedures are conducted in specialized suites, often under sedation or general anesthesia, by teams that typically include interventional radiologists, neurosurgeons, neurologists, and anesthesiologists.

Training and professional practice vary by country, but the field generally requires advanced fellowship training in interventional neuroradiology after residency in radiology or neurosurgery, with board certification or credentialing in many regions. The field has evolved rapidly with advances in device technology and imaging, contributing to improved outcomes for certain vascular and neuro-oncologic conditions, while carrying risks such as stroke, bleeding, vessel injury, infection, and contrast-related complications.

Access to neurointerventions depends on resources and expertise, and ongoing research seeks to expand indications, refine devices, and improve patient selection and safety.