UCSF Neurointerventional Radiology

Fifty years ago, it would have seemed unfathomable that clots in the brain could be treated just by accessing the patient’s leg, but with the advent of neurointerventional radiology, such procedures have become much more commonplace. A small incision in the femoral artery in the upper thigh allows surgeons to pass a catheter through the patient’s vascular system to reach arteries in the head and neck and treat a variety of conditions from strokes to brain tumors to dural arteriovenous fistulas (abnormal connections between the arteries and veins of the membrane covering the brain). The surgeons track the movements of the catheter by using an x-ray to visualize the position of the catheter and the patient’s vasculature in real-time. The BIE students had the opportunity to visit the Neurointerventional Radiology department at UCSF and meet Dr. Steven Hetts, Associate Professor of Radiology.

These X-ray machines and monitors are used by the neurointerventional radiology team to visualize the catheter’s position and movement in real-time.

During our visit, we observed two procedures under Dr. Hett’s supervision: an angiogram and a preoperative embolization for a patient suffering from meningioma. A cerebral angiogram involves a series of x-rays of the head that display the blood vessels in the brain by utilizing a contrast medium. During the angiogram, we were able to see the patient’s vasculature as the surgeons passed the catheter through the patient’s arteries. In addition, we could see the coil in the patient’s brain that had previously been placed by Dr. Hetts’s team to prevent rupture of the patient’s aneurysm. The coil was much larger than we expected! Dr. Hetts confirmed through the procedure that the coil had been successful in preventing blood flow to the aneurysm site. For the second procedure, the patient suffered from a brain tumor that the neurointerventional radiology team worked to embolize. Reducing blood flow to the tumor is beneficial in preventing blood loss and facilitating the tumor removal surgery. The patient was successfully embolized on Wednesday, and the surgical team planned to remove the tumor on Friday. We ended our day at UCSF neurointerventional radiology with a department-wide conference where surgeons and physicians met to discuss several cases and determine the appropriate measures to take in treating the patients.

The Artis x-ray systems from Siemens Healthcare are used for visualization during the neurointerventional radiology procedures.

Visiting UCSF Neurointerventional Radiology was a fantastic experience for BIE students to learn more about the cutting edge imaging technology used by surgeons. We were able to learn more about the needs of the various stakeholders involved in the department and created a list of needs related to embolization agents, patient communication and records, and catheter maneuvering and delivery. We’d like to thank Dr. Hetts and the entire UCSF Neurointerventional Radiology team for giving us this wonderful opportunity!