This page is under development. Please check back soon for information on more of the treatments offered at the Institute.
Endovascular Aneurysm Surgery
Endovascular treatment is sometimes used as an alternative to open surgery. During endovascular treatment for an aneurysm, a catheter -- a small flexible tube -- is guided through the groin area into the femoral artery where it is then threaded up through the vascular system to the location of the aneurysm. During the procedure, our specially trained neurosurgeons are able to see the vascular system using fluoroscopic imaging, which maps out the arteries through which the catheter and coils will travel to the site of the aneurysm. Small platinum coils are then inserted into the aneurysm, blocking the flow of blood into the bulge in the blood vessel. The filling of the aneurysm with coils is called embolization.
At the Stroke and Cerebrovascular Center of New Jersey, neurosurgeons also use glue as another endovascular treatment option for aneurysm. The Onyx® Liquid Embolic System (Onyx® HD-500) is an artificial material used to block blood flow into aneurysms. The material is used to fill the aneurysm space and prevent the aneurysm from rupturing or increasing in size.
Surgery for treatment of an aneurysm involves the opening of the skull during a craniotomy. The aneurysm is then accessed by carefully separating it from the brain tissue that surrounds it. A small metal clip is placed at the base of the aneurysm, closing off the opening between the artery and the aneurysm, essentially preventing blood from flowing into the aneurysm. This then eliminates the aneurysm, as it is no longer under the pressure of direct blood flow. The aneurysm then essentially disappears.
Surgical removal of an arteriovenous malformation (AVM) is performed by first removing a section of the skull, called a craniotomy. The neurosurgeon seals off the AVM using special clips and then carefully removes the AVM from the surrounding brain tissue. The skull bone is replaced and the incision is closed. The blood vessels removed are not supplying blood to normal brain tissue and are removed in their entirety.
Endovascular AVM Treatment
Endovascular treatment of an AVM is less invasive than open surgery and can be used to help treat AVMs located deeper in the brain. During the procedure, coils or glue are introduced into the AVM through a catheter. These substances serve as an obstruction to the blood flowing into the AVM. This procedure can be used prior to surgical removal of an AVM and can decrease the risks associated with the open surgery by decreasing the amount of blood in the AVM. By dramatically decreasing the size of the AVM, radiosurgery is also more effective with a higher cure rate. Radiosurgery is a non-invasive form of surgery that slowly closes down the abnormal blood vessels.
Carotid Angioplasty and Stenting
This procedure is performed to open up a carotid artery that is being closed off due to a build up of plaque. A build up of fat and cholesterol in the internal carotid artery causes plaque to form in the arteries through a process called atherosclerosis. During this procedure, a balloon is inflated inside the blood vessel to press the plaque up against the walls of the artery. A stent – which looks like a small mesh tube -- is then placed where the inflated balloon was and keeps the wall of the artery pushed open following the procedure.
During this procedure, one of our neurosurgeons makes an incision in the carotid artery and removes plaque that has built up. Once the plaque is removed, blood flow improves through the artery. This procedure helps prevent stroke.
Intravenous and Intra-Arterial Thrombolysis and Mechanical Thrombectomy
Used to treat stroke, thrombolysis is the removal of a blood clot, which is blocking the flow of blood to the brain. This can be done through pharmacological means using drugs frequently referred to as “clot busters”. These drugs are given through an IV and released into the blood stream. Mechanical thrombectomy is the removal of the clot using non-pharmacological means. If IV medication does not open the clot, mechanical thrombolysis is the only means to open the blood vessel and salvage brain that is being deprived of oxygen. At the Stroke and Cerebrovascular Center of New Jersey, our neurosurgeons use the Merci Retriever, Penumbra device and intracranial stenting to remove clots and open up blood vessels that are being blocked. This treatment can only be performed at a designated comprehensive center.
The information provided on these educational pages is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. And, if experiencing a medical emergency call 9-1-1.