Neurointerventional radiology focuses on diagnosis and treatment of abnormalities of the nervous system, spine, head and neck. This rapidly advancing specialty provides imaging of and minimally invasive treatment for conditions, such as aneurysm or stroke, which previously may have required major surgery.
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NeuroInterventional Radiology at TRA
TRA has three dedicated board certified radiologists with extensive specialized fellowship training in diagnostic and neurointerventional radiology. We also have experienced, certified physician assistants, registered technologists and nurses as a part of our care team. Consultations, follow-up appointments and some procedures are held at our Neuro/Interventional Radiology Outpatient Clinic in Tacoma. This outpatient clinic is equipped to offer more than just diagnosis through imaging. We also provide minimally-invasive therapies for tumors, aneurysms, vascular malformations, and stroke.
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Find TRA locations for NeuroInterventional Radiology
Types of NeuroInterventional
Radiology Procedures
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Brain aneurysm coiling
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Brain aneurysm coiling is the minimally invasive treatment for hemorrhagic stroke, a type of stroke that involves bleeding within the brain and is commonly caused by an aneurysm in the brain. Brain aneurysms can be treated and hemorrhagic stroke prevented by placing tiny platinum coils into the aneurysm using an image guided procedure. The coils block blood flow into the aneurysm and prevent rupture.
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Carotid artery stenting
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Carotid artery stenting is used to treat narrowing in the carotid artery, often caused by plaque. Plaque in the artery may result in an ischemic stroke by either decreasing blood flow to the brain or by breaking loose and depriving a portion of the brain of blood flow. In patients at high risk of having a stroke, the narrowed section of artery may be reopened through angioplasty and reinforced with a stent (a small mesh tube), to prevent the stroke from occurring.
Watch the video below to see a stent placement.
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Intracranial stent placement
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Intracranial stent placement is used to treat the narrowing of the arteries within the brain. Plaque in the artery may result in an ischemic stroke by either decreasing blood flow to the brain or by breaking loose and depriving a portion of the brain of blood flow. In patients at high risk of having a stroke, the narrowed section of artery may be reopened through angioplasty and reinforced with a stent (a small mesh tube), to prevent the stroke from occurring.
Watch the video below to see a stent placement.
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Clot-dissolving drugs
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Clot-dissolving drugs are used to dissolve blood clots and limit the damage caused by blockage of the blood vessel. These drugs are usually effective if administered intravenously within three hours of an ischemic stroke. However, for patients who are unable to get treatment that quickly, or are not good candidates for receiving this treatment intravenously, these clot-dissolving drugs can be delivered directly to the site of the clot using image guidance. This lengthens the amount of time that can pass (approximately six hours) before the drugs can be administered effectively, and allows more patients access to treatment.
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Petrosal sinus sampling (PSS) for Cushing’s Disease
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Using x-ray imaging and a contrast material to visualize the blood vessel, your neurointerventional radiologist inserts a catheter (through a nick in the skin) into a blood vessel and advances it to the jugular vein in the neck. From there it is passed into a smaller vein that drains blood directly from the pituitary gland, known as the inferior petrosal sinus. The procedure is repeated for the other side. Once the catheters are in place, blood samples will be taken from the right and left petrosal sinus and an arm vein at exactly the same time. After two baseline samples, a hormone called CRH is injected into the arm vein. Further blood samples are taken for another 10 to 15 minutes. Often sampling may be continued from your arm vein only, for a total of 90 minutes. You will be asked to remain lying on your back for at least 2 hours afterwards.
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Treatment for atervenous malformation (AVM)
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Arteriovenous malformation (AVM) is an abnormal connection between an artery and vein, most often found in the brain or spinal cord. Blood may flow directly from the artery to the vein, keeping blood from fully circulating and from delivering oxygen where it is needed.
How it works: Catheter embolization is used to treat this disease. Using x-ray imaging and a contrast material to visualize the blood vessel, your neurointerventional radiologist inserts a catheter (through a nick in the skin) into a blood vessel and advances it to the treatment site. A medical material made up of tiny particles (called an embolic agent) is then inserted through the catheter. The embolic agent will block the blood vessel and reduce blood flow into the AVM.
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Treatment for Epistaxis (Nosebleeds)
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Epistaxis can be treated with catheter embolization. Using x-ray imaging and a contrast material to visualize the blood vessel, your neurointerventional radiologist inserts a catheter (through a nick in the skin) into a blood vessel and advances it to the treatment site. A medical material made up of tiny particles (called an embolic agent) is then inserted through the catheter. The embolic agent will block the blood vessel and reduce blood flow into affected areas of the nose and sinus.
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Tumor Embolization
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Tumor embolization is used to close off the vessels supplying blood to a tumor, especially when the tumor is difficult or impossible to remove.
How it works: Your neurointerventional radiologist uses x-ray imaging and a contrast material to visualize the blood vessel. He or she inserts a catheter (through a nick in the skin) into the blood vessel and advances it to the treatment site. A medical material made up of tiny particles (called an embolic agent) is inserted through the catheter and directed to the tumor. The embolic agent will block the blood vessels that supply blood to the tumor. Following embolization, the tumor will likely shrink or grow more slowly than before.
