neurointerventional

Neurointerventional refers to the practice of minimally invasive endovascular and percutaneous techniques used to diagnose and treat disorders of the brain, spine, and head and neck vessels. It is a subspecialty of interventional radiology and neuroradiology that combines imaging, catheter-based therapy, and neurocritical care to manage cerebrovascular diseases and selected tumors and malformations.

During a typical neurointerventional procedure, a diagnostic cerebral or spinal angiogram is performed to map blood vessels, followed by therapeutic intervention such as coil embolization or flow-diverting stents for intracranial aneurysms, mechanical thrombectomy or thrombolysis for acute ischemic stroke, embolization of arteriovenous malformations or fistulas, and selective embolization of spinal or cranial tumors. Liquid embolic agents (e.g., NBCA, Onyx), microcatheters, balloons, stents, and coils are among the common tools. Procedures may be performed via transfemoral or radial arterial access, under fluoroscopic and often 3D imaging guidance.

Indications include acute stroke, aneurysmal disease, cerebral and spinal vascular malformations, dural arteriovenous fistulas, tumor vascularization, and certain palliative or preoperative embolizations. The field emphasizes rapid treatment, tissue preservation, and multidisciplinary collaboration with neurology, neurosurgery, and intensive care.

Training and practice: neurointerventionalists are physicians trained in radiology, neurology, or neurosurgery who complete dedicated fellowships in neurointerventional radiology or equivalent, followed by certification and ongoing credentialing. Procedures are concentrated in specialized centers with appropriate imaging suites and anesthesia support.

Safety and outcomes: as with all invasive vascular procedures, risks include stroke, vessel injury, contrast reactions, and infection; outcomes have improved with advances in devices and imaging.