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Interventional Neuroradiology

ICU lecture - 2011

Gwendolyn Dooley

on 19 August 2012

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Transcript of Interventional Neuroradiology

Overview Occluding Vessels Interventional Neuroradiology Inside the brain plumbers Subarachnoid Hemorrhage
AVM/Tumor Embo
Endovascular stenting
Acute Stroke
DST Thrombectomy SAH and AVM Embolization The objective
is to either open
a vessel up or to
shut it down Elective vs. Acute Hunt & Hess grade can dictate
outcome and treatment SAH - 1/3 Acute Stroke
Dural Sinus Thrombosis
Stenosis Special Considerations Groin Care
Pressure - Safe guard - Femstop
Ultrasound vs. CT Aspirin & Plavix Revascularization Acute Stroke
Decision to treat is made based upon CTP. Endovascular Stenting
70 % or greater stenosis or symtomatic despite best medical therapy Dural Sinus Thrombosis
Delicate balance regarding treatment Stroke devices - Pneumbra, Solitaire, IA meds Treatment dependent upon the extent on the clot and if edema is present. Anticoagulation is key You hold the power of making a difference in your hands every day. Therapeutic levels are the goal
Extremely important in patients with newly placed stents Some interaction with proton pump inhibitor medications & some patients are genetic non-responders - options include lovenox, aggrenox, effient. Contrast Dye Allergy Renal Insufficiency Pretreated with Bendryl & Steroids Considered creatinine of > 1.3
Treated with mucomyst & increased fluids
Alternative contrast is used. You are the first line of defense, please let us know if any of these issues occur. Thank you for your time,
Welcome to the team!!! INR Interventional Neuroradiology lll
Full transcript