MedicalCRITERIA.com

Unifying Concepts

Indications and Recommendations for Intracranial Endovascular Neurointerventional Procedures

Intracranial endovascular cerebrovascular interventions treat cerebrovascular diseases by use of minimally invasive intravascular techniques.

Indications and Recommendations for Endovascular Procedures

Indications Recommendations
Cerebral aneurysm
Ruptured with SAH If amenable to endovascular treatment according to endovascular specialist Should be considered for endovascular occlusion
Unruptured If amenable to endovascular treatment according to endovascular specialist Reasonable to consider endovascular occlusion
Intracranial atherosclerosis
Symptomatic stenosis For symptomatic atherosclerotic stenosis >70% failing medical therapy May be reasonable to consider endovascular revascularization with angioplasty or stenting
Acute ischemic stroke
Intra-arterial
thrombolysis
For patients with major stroke syndrome of <6 hours’ duration and ineligible for intravenous thrombolysis Reasonable to consider intra-arterial thrombolysis in selected patients
Mechanical disruption For patients with major stroke syndrome of <8 hours’ duration and ineligible for or failing intravenous thrombolysis May be reasonable to perform mechanical disruption to restore cerebral blood flow in selected patients
Cerebral AVM
Pial AVM For patients with hemorrhage referable to the AVM, endovascular treatment in combination with other therapies such as surgery or radiosurgery May be considered as a preoperative adjunct or palliative treatment in an effort to prevent recurrent hemorrhage
Dural AV fistula For patients with neurological symptoms or
hemorrhage referable to the AVM, endovascular treatment alone may be curative or may be used in combination with other therapies such as surgery or radiosurgery
May be considered as a preoperative
adjunct or palliative treatment in an effort to prevent stroke or hemorrhage

SAH indicates subarachnoid hemorrhage; AVM, arteriovenous malformation.

 

References:

  1. Meyers PM, Schumacher HC, Higashida RT, Barnwell SL, Creager MA, Gupta R, McDougall CG, Pandey DK, Sacks D, Wechsler LR; American Heart Association. Indications for the performance of intracranial endovascular neurointerventional procedures: a scientific statement from the American Heart Association Council on Cardiovascular Radiology and Intervention, Stroke Council, Council on Cardiovascular Surgery and Anesthesia, Interdisciplinary Council on Peripheral Vascular Disease, and Interdisciplinary Council on Quality of Care and Outcomes Research. Circulation. 2009 Apr 28;119(16):2235-49 [Medline]
  2. Qureshi AI, Abou-Chebl A, Jovin TG. Qualification requirements for performing neurointerventional procedures: a Report of the Practice Guidelines Committee of the American Society of Neuroimaging and the Society of Vascular and Interventional Neurology. J Neuroimaging. 2008 Oct;18(4):433-47. [Medline]

 

Created: Nov 29, 2010

  • Language:

  • Users Online

  • Medical Disclaimer

    El contenido de este sitio web son solo para fines informativos y no reemplazan la consulta con un profesional médico.
  • Recent Posts

  • Categories

  • Copyright by MedicalCriteria.com