Emergency Neurointerventional Procedures

Introduction: New developments in materials and techniques have made endovascular neuroradiological procedures (i.e., interventional neuroradiology [a.k.a. endovascular surgery]) the method of choice, with equal or better outcome and less risk compared with an operative approach in cases such as carotid artery stenting and coiling of intracranial aneurysms. These interventional techniques can also be employed in emergency situations, especially hemorrhage of various causes in the neck and skull base.

Methods: Life-threatening hemorrhage (e.g., that occurs in tumor infiltration of the extracranial carotid artery or intractable nasal bleeding) can be treated with the same techniques that are used in preoperative embolization of a tumor or occlusion of an aneurysm. The use of microcatheters and different embolization materials (particles, glue, coils) is often a valid alternative to an operative approach.

Results/Discussion: A neurointerventional unit can be of assistance to ENT and skull base surgeons in treating vascular emergencies, especially acute hemorrhage. Such a service should be available 24/7 and be staffed by a team of neuroradiologists and technicians that is familiar with all types of procedures so that the most appropriate technique can be applied in a given situation.