Endovascular
Stroke Treatment
Dr. Nishant Aditya
Breach Candy Hospital
Saifee Hospital
Reliance Foundation
Prince Aly Khan Hospital
Fortis Hospitals
Jupiter Hospital
Fortis Hospitals
Dr.L.H Hirandani Hospital
Dr. Nishant Aditya has worked in the Division of Interventional Neuroradiology at King Edward Memorial (KEM) Hospital.
He is a Consultant Interventional Neuroradiologist at Breach Candy Hospital, Saifee Hospital , Wockhardt Hospital, Prince Aly Khan Hospital , Fortis Hospital, Mulund, Jupiter Hospital, Thane and Dr. LH Hiranandani Hospital, Powai .
He is a frequent participant and contributor to local Academic meets of Scientific Societies like Bombay Neurosciences Association, Monthly Bombay Interventional Neuroradiology Meets.
Mechanical Thrombolysis (Removal of blood clot from Brain Circultaion) :
Paralysis occurs due to lack of blood supply to Brain by blood clot, in this situation if patients reach centres (where Interventional Neuroradiology is available) within 6-8 hrs Blood CLOT can be removed and Normal blood flow to brain will be restored .
Example- 69 Yrs. old lady presented with Rt. side Paralysis and loss of speech. She reached hospital within 5 hrs. (Golden hour for Treatment of Stroke due to lack of blood supply to Brain). After removal of Clot from Brain Circulation , she recovered completely.
Stenting of Neck Arteries(Opening of Blockage) :
More than 70%- 90% blockage of Neck Arteries cause Paralysis due to ‘TRANSIENT’ lack of blood supply to Brain .
In this situation by Interventional Neuroradiology techniques BLOCKAGE can be opened and Normal blood flow to brain will be restored .
Example- A gentleman presented with transient Rt. side facial Paralysis due to more than 95 % blockage of Neck Artery. After removal of blockage by STENTING , he never had these episodes.
Stenting of Brain Arteries(Opening of Blockage) :
More than 70%- 90% blockage of Brain Arteries cause Paralysis due to ‘TRANSIENT’ lack of blood supply to Brain .
In this situation by Interventional Neuroradiology techniques BLOCKAGE can be opened and Normal blood flow to brain will be restored .
Example- BLOCKAGE A gentleman presented with transient Rt. side facial Paralysis due to more than 95 % blockage of Brain Artery. After removal of blockage by STENTING , he never had these episodes.
Dural Sinus Thrombolysis [Dissolving the blood clot from Major Brain Venous System (DURAL SINUSES)] :
In this situation blood outflow system of Brain(DURAL SINUSES) is clogged by blood clots.With Interventional Neuroradiological Techniques ,Without opening the Skull ; these Blood CLOTS can be dissolved and normal blood overflow from brain will be restored.
Example- 65 Yrs. old gentleman presented with multiple episodes of fits and loss of Consciousness. After Dissolutiuon of blood clot from Major Brain Venous System (DURAL SINUSES), he recovered completely.
Coiling of Brain Aneurysm (Responsible for Brain Hemorrhage) :
Sub Arachnoid Hemorrhage(SAH) is one of type of Brain hemorrhage, which occurs in the inner covering of Brain known as Subarachnoid Space due to bursting of Aneurysm(abnormal Ballooning of Brain artery). With Interventional Neuroradiological Techniques ,Without opening the Skull ; these Aneurysms can be treated by various technique e.g.: Balloon Assisted, Stent Assisted Coiling etc.
Example-60Yrs. old lady presented with severe headache & loss of consciousness due to Brain hemorrhage from Aneurysm. After COILING of ANEURYSM , she recovered completely.
Embolisation of Brain Arteriovenous Malformation, BAVM (Abnormal cluster of blood vessels in Brain) :
Intra Cerebral Hemorrhage(ICH) is one of type of Brain hemorrhage, which occurs in the substance of Brain due to bursting of Abnormal cluster of blood vessels in Brain. With Interventional Neuroradiological Techniques ,Without opening the Skull ; these Abnormal cluster of blood vessels in Brain can be treated by various technique e.g.: ONYX , Glue Embolisation etc.
Example:45 Yrs. old gentleman presented with severe headache &Lt. side paralysis due to Brain hemorrhage from Brain AVM. After ONYX Embolisation of Brain AVM ,he recovered completely.
Embolisation of Dural Arteriovenous Fistula, DAVF (Abnormal cluster of blood vessels on Brain Covering):
Intra Cerebral Hemorrhage(ICH) is one of type of Brain hemorrhage, which occurs in the substance of Brain due to bursting of Brain Venous system because of high flow and pressure into them exerted by Abnormal cluster of blood vessels on Brain Covering (Duramater). With Interventional Neuroradiological Techniques,Without opening the Skull ; these Abnormal cluster of blood vessels on Brain Covering can be treated by various technique e.g.: ONYX , Glue Embolisation etc.
Example : 35 Yrs. old gentleman presented with severe headache & loss of Consciousness due to Brain hemorrhage from Brain DAVF. After ONYX Embolisation of Brain DAVF ,he recovered completely.
Treatment of Cavernous Dural AVM & CCF (Abnormal Cluster of blood Vessels behind Eye Socket causing BULGING of Eye.) :
Example- 50 Yrs. lady presented BULGING of Lt. Eye with due to Cavernous Dural AVM. After Embolisation , resolution of eye swelling happened within hours
Embolisation of Spine Arteriovenous Malformation,SCAVM (Abnormal cluster of blood vessels in Spinal Cord):
These are abnormal Connections between Arteries and Veins in Spine causing increase in pressure in Spinal Veins causing paralysis. With Interventional Neuroradiological ,Without opening the Spine ; these Connections between Arteries Abnormal and Veins in Spine can be treated by technique of Glue Embolisation .
Example: 4 Yrs. kid presented with leg paralysis due to spinal hemorrhage from AVM. After GLUE Embolisation he recovered completely.
Embolisation of Vein Of Galen Aneurysmal malformation (VOGAM) :
very rare disease of Blood vessels of Brain of Child. With advent of Good Ultrasound Machines, it can be diagnosed at the time of ongoing Pregnancy.This is one of the very few disease of Brain Artery which can be diagnosed in Womb.
These are abnormal Connections between Arteries and Veins in Brain causing increase in pressure in Brain Veins causing Heart Failure, Stunted Growth or Fits/ Epilepsy.
With Interventional Neuroradiological ,Without opening the Skull ; these Connections between Arteries Abnormal and Veins in Brain can be treated by technique of Glue Embolisation .
Example: 4 month old baby boy presented with Stunted Growth and large head due to Vein Of Galen Aneurysmal malformation (VOGAM). After GLUE Embolisation of Vein Of Galen Aneurysmal malformation (VOGAM), now he is growing at normal stages.
Embolisation of Brain Arteriovenous Fistula, AVF (Abnormal Connection between Artery and Vein in Brain):
These are abnormal Connections between Arteries and Veins in Brain causing increase in pressure in Brain Veins causing Fits/ Epilepsy.
With Interventional Neuroradiological ,Without opening the Skull ; these Abnormal Connections between Arteries and Veins in Brain can be treated by technique of Glue Embolisation .
Example : 14 Yrs. girl presented with fits due to Brain PIAL AVF. After GLUE Embolisation of Brain AVM ,she didn’t have fits.
What is Interventional Neuroradiology ?
Interventional Neuroradiology or Endovascular Neurosurgery is a minimally invasive procedure (Without opening the Skull) which cures diseases of blood vessels of the Central Nervous System with minimal trauma to the human body. Brain blood Vessels are approached through a ‘small hole’ in thigh Artery.With the advent of these Interventional Neuroradiology techniques, treatment is possible with very low risk and short hospital Stay.
Interventional Neuroradiology or Endovascular Neurosurgery offers treatment for Paralysis within 6-8 hours of onset of symptoms , by removal of blood clot from circulation. With procedures like ‘Carotid Stenting’ and ‘Intracranial Stenting’ Stroke can be prevented in future by removal of significant blockage of Neck and Brain arteries Arteries.
What is Interventional Neuroradiology ?
Interventional Neuroradiology or Endovascular Neurosurgery is a minimally invasive procedure (Without opening the Skull) which cures diseases of blood vessels of the Central Nervous System with minimal trauma to the human body. Brain blood Vessels are approached through a ‘small hole’ in thigh Artery.With the advent of these Interventional Neuroradiology techniques, treatment is possible with very low risk and short hospital Stay.
Interventional Neuroradiology or Endovascular Neurosurgery offers treatment for Paralysis within 6-8 hours of onset of symptoms , by removal of blood clot from circulation. With procedures like ‘Carotid Stenting’ and ‘Intracranial Stenting’ Stroke can be prevented in future by removal of significant blockage of Neck and Brain arteries Arteries.
Brain hemorrhage is a catastrophe and Aneurysms are a dominant and Treatable cause of Subarachnoid hemorrhage. Coiling with different techniques of Interventional Neuroradiology or Endovascular Neurosurgery is very safe option.
Similarly, ONYX Embolisation for Brain Arteriovenous Malformation (BAVM), Dural Arteriovenous Fistula (DAVF); Embolisation of Spinal Cord Arteriovenous Malformation (SCAVM), Spinal Cord Arteriovenous Fistula (SCAVF) and in Children Embolisation of Pial Arteriovenous Fistula , Vein of Galen Aneurysmal Malformation (VGAM) can be done with low risk to normal brain.
Dr. Nishant Aditya has worked in the Division of Interventional Neuroradiology at King Edward Memorial (KEM) Hospital.
He is a Consultant Interventional Neuroradiologist at Breach Candy Hospital, Saifee Hospital , Wockhardt Hospital, Prince Aly Khan Hospital , Fortis Hospital, Mulund, Jupiter Hospital, Thane and Dr. LH Hiranandani Hospital, Powai .
He is a frequent participant and contributor to local Academic meets of Scientific Societies like Bombay Neurosciences Association, Monthly Bombay Interventional Neuroradiology Meets.
List of Endovascular Operations for Stroke
Dr. Nishant Aditya
(Sir HN Reliance Foundation Hospital)