neuro angiological interventions Flashcards
radiology can be used for two main things
diagnosis and interventions
examples of interventions
- thrombectomy (stroke, remove clot)
- embolisation of aneurysms or arteriovenous malformations
- stenting
- embolisation of vascularized tumors
what do we need to check before giving blood thinners?
if there is bleeding in the brain -> NO blood thinners
stroke treatment: difference between before and now
before: only blood thinners
now: thrombectomy and blood thinners
how long does a thrombectomy take?
it can take about 1 hour
how does ischaemia look on imaging? advantage of MRI?
big white area
MRI -> better contrast resolution
what does EVT stand for?
endovascular therapy
what is one problem with automated analysis of the CT perfusions?
algorithms were made for large vessel occlusions, not distal occlusions
which method had the most successful recanalization?
stent retriever + aspiration catheter
why is blind mini-pinning not good?
pulling on the retriever stent can stretch the vessel and cause bleeding (doesn’t follow the normal anatomy of the vessel)
difference between true aneurysms and dissection/pseudoaneurysms, what is one cause of aneurysms? (related to where they happen most often)
true -> maintain all three layers of vessel wall
other two -> separate one or more layers
high wall shear stress (at bifurcations f.ex) -> breakdown of smooth muscle cells and degradation of elastic lamina
does genetic have an influence in aneurysm formation?
yes, genetic components alter the response to shear stress and inflammation
if one aneurysm, look for others
aneurysm treatments: give all the options and for which type of aneurysm they are used
1) old school: clipping -> open surgery
2) coiling -> small neck aneurysms (in wide neck, the coils could come out and occlude vessels)
3) web device -> broad base aneurysms
4) flow diverter -> broad and in a curve -> aneurysm will shrink if flow diverted
