State-of-the-art neurointervention and stroke care
Neurointervention―also known as endovascular neurosurgery or interventional neuroradiology (INR)―is the use of advanced imaging and three-dimensional technology to diagnose and treat complex conditions in the brain, such as stroke and aneurysm, that would otherwise require open surgery.
This minimally invasive approach involves inserting a catheter―a small, thin tube―through the patient's groin or wrist, and threading that catheter through an artery―or blood vessel―into the brain using state-of-the-art guided imaging. Skilled experts can then pass tools through the catheter to perform a variety of procedures, including coiling, stenting, angioplasty and embolization.
Applying these highly specialized, innovative techniques in the treatment of complicated neurologic disorders results in decreased pain, faster recovery, shorter hospital stays, and a lower risk of complication when compared with open surgery. Many procedures require only mild sedation.
Community health system, unique neurointervention care capabilities
Main Line Health is one of few community health systems offering state-of-the-art neurointervention care.
Paoli Hospital is a nationally recognized Primary Stroke Center, certified by The Joint Commission, with a state-of-the-art Neurointervention Lab that offers the most advanced diagnostics and treatments available for patients experiencing stroke. In collaboration with Jefferson Health Neurosurgery and Tele-Neurocritical Care Services, the lab provides leading neurointervention care to Chester County.
Through our collaboration with the Jefferson Hospital for Neuroscience, Bryn Mawr Hospital is a Thrombectomy-Capable Stroke Center (TSC) certified by The Joint Commission, in collaboration with the American Heart Association/American Stroke Association (AHA/ASA), offering rapid access to advanced diagnostics and treatment right here in the community. And our multidisciplinary team of specialists provides the complete continuum of postsurgical care.
Patients also have access to the full complement of neurosurgery and neurointervention services offered at Jefferson Health. Care coordination ensures that people who go to Jefferson Health for specific services have a seamless experience and access to specialists in neurology, neurosurgery, comprehensive neurovascular care and neurorehabilitation.
Cutting-edge capabilities, combined with the personalized, compassionate care Main Line Health is known for, ensure an exceptional patient experience and the best possible clinical outcomes. It is our goal to not only save lives, but to restore function, enabling patients to get back to the activities they enjoy and continue leading full, productive lives.
We use advanced neuroimaging, including magnetic resonance imaging (MRI), computed tomography (CT or CAT) scan, CT angiography (CTA), CT perfusion (CTP), and three-dimensional (3D) digital subtraction angiography (DSA) to diagnose the entirety of complex neurovascular conditions.
Most notably, our neurointervention team utilizes Viz.ai, a state-of-the-art technology application that ensures patients experiencing stroke receive care as safely and quickly as possible. The Viz.ai software is embedded inside our imaging equipment, and applies artificial intelligence to detect a clot, pinpoint its exact location, determine the severity, and immediately alert our entire multidisciplinary team via cell phone.
Where it previously took up to an hour for a scan to be read by a radiologist and the team to be notified, mobilization now occurs in minutes.
Where it previously took up to an hour for a scan to be read by a radiologist and the team to be notified, mobilization now occurs in minutes. Clinicians are able to view detailed images on cell phones or computers, and communicate directly with one another regarding critical next steps.
Conditions treated through neurointervention
The most common condition treated through neurointervention is stroke. Stroke is the fifth leading cause of death in the United States and the number one leading cause of disability. In the U.S., approximately 795,000 people suffer a stroke each year.
There are two kinds of strokes―acute ischemic stroke and hemorrhagic stroke. Eighty-seven percent of strokes are acute ischemic stroke, meaning there is a clot or clog within a blood vessel blocking blood flow to the brain and depriving it of oxygen. There are multiple causes for ischemic stroke, including carotid stenosis―a narrowing of the arteries in the neck, and intercranial stenosis―a narrowing of the arteries in the brain.
Hemorrhagic stroke, which represents 13 percent of strokes, involves bleeding in the brain caused by an aneurysm or an arteriovenous malformation (AVM). In both acute ischemic and hemorrhagic stroke, timely identification and treatment is critical.
Additional conditions treated through neurointervention include:
- Unruptured brain aneurysms
- Subdural hematomas (brain bleeds)
- Vascular malformations
- Brain tumors
- Spine tumors
- Moya Moya disease
Main Line Health offers the most cutting-edge neurointervention treatment options available.
Among the most common is thrombectomy to treat acute ischemic stroke. This involves traveling up to the brain through a catheter inserted in the groin or wrist and using a retrievable stent device to extract a clot. This safe and effective treatment allows us to restore blood flow to the brain and in many cases, reverse stroke symptoms and reduce brain injury before it becomes permanent. This highly specialized procedure is currently performed at Bryn Mawr Hospital and and is now available at Paoli Hospital.
In the case of a brain aneurysm, our skilled experts will perform an endovascular embolization procedure, such as coiling. Coiling involves using microcatheters to reach inside the bubble of an aneurysm and pack it with tiny platinum coils that block blood flow from entering, preventing the aneurysm from ever rupturing. It is an approach that cures aneurysms from the inside out.
Our experts also perform procedures such as stenting and balloon angioplasty for carotid stenosis―a narrowing of the arteries in the neck, or intercranial stenosis―a narrowing of the arteries in the brain, to open up arteries and prevent future stroke.
Related diagnostic and treatment options include:
- Brain aneurysm clipping
- Carotid endarterectomy
- Computed tomography (CT or CAT) scan
- Flow diversion
- Magnetic resonance imaging (MRI)
- Positron emission tomography/computed tomography (PET/CT) scan
The Neurointervention Program at Main Line Health has met stringent quality standards for stroke treatment set by the Joint Commission as well as those of the American Heart/Stroke Association, making our hospitals among the top stroke hospitals in the Philadelphia region. Bryn Mawr Hospital is a Joint Commission-certified, Thrombectomy Capable Stroke Center, a designation bestowed on only one of three hospitals in the State of Pennsylvania.
For 2021, overall hemorrhagic conversion at Main Line Health is 14% and tPA transformation is 4%.