Types of neurosurgical endovascular therapy

Endovascular neurosurgery contains ten aspects of therapeutic techniques: i. Particle embolization: microcatheter is super-selectively inserted into the blood-supplying artery of the lesion, and solid tethered particles are aspirated with a syringe and injected through the microcatheter to utilize the natural blood impact to bring the particles into the foci and carry out intra-lesion embolization. This technique is mainly used in the treatment of dural and spinal arteriovenous fistula, spinal cord AVM, preoperative embolization of meningioma, head and face AVM, visceral AVM, etc. Second, detachable balloon embolization: the special latex or silicone balloon installed in the coaxial catheter, Magic-BD or Magic-BD-2L catheter end, through the guide tube to the lesion will be released to fill the aneurysm cavity, block the aneurysmal arteries or block the fistula to achieve the therapeutic purpose, the method is mainly used in the treatment of intracranial aneurysms, internal carotid artery aneurysm, spongiotic sinus fistula, vertebral arteriovenous fistulae and spinal artery fistulae. This method is mainly used for the treatment of intracranial aneurysm, giant aneurysm of internal carotid artery, carotid cavernous sinus fistula, vertebral arteriovenous fistula and so on. Xiong Hui, Department of Neurosurgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine 3, open hole balloon embolization technology: the special open hole balloon installed in the end of microcatheter, through the guide tube to the lesion of the blood artery, through the microcatheter injection of liquid embolization agent to embolize the lesion, mainly used for the treatment of cerebral arteriovenous malformations, Galen’s venous aneurysm, but also injected into the brain of gliomas can also be injected into the super-selective chemotherapy or injected into the thrombolytic drug line of cerebral thrombosis treatment. It can also be used to inject chemotherapeutic drugs for super-selective chemotherapy of glioma or thrombolytic drugs for cerebral thrombosis. Intraluminal vasodilatation and angioplasty: Insert the special microcatheter of balloon expansion into the site of intracranial vascular stenosis or spasm, inject the low concentration contrast agent through the catheter to pressurize the balloon (2-3 atmospheres) to fracture the atherosclerotic plaques on the inner wall of stenosis and blood vessels, and the vasculature will be restored again and the vasodilation or spasm lifted as the vasodilatation or angioplasty method of treatment. It is mainly used for the expansion of intracranial artery stenosis, subarachnoid hemorrhage and cerebral vasospasm after aneurysm surgery. Micro spring coil embolization technology: The special tungsten or platinum spring coil is sent to the lesion through the micro catheter with super-selective intubation in place to achieve the purpose of embolization treatment. Mainly used for cerebral aneurysm, carotid cavernous sinus fistula, dural arteriovenous fistula endovascular treatment. Six, electrolysis platinum spring coil embolization technology: the electrolysis platinum spring coil by ultra-selective intubation in place of the microcatheter into the lesion, such as confirmation of embolization of the lesion, the platinum spring coil through the direct current will be released to achieve the purpose of embolization therapy. It is used for embolization of intracranial saccular aneurysm. Mechanical release of tungsten spring coil embolization technology: the special tungsten spring coil is sent into the lesion through the microcatheter with super-selective intubation in place. If it is confirmed that the lesion will be embolized, the robot will be loosened, and the tungsten spring coil will be left in the lesion to achieve the therapeutic purpose. This technique is mainly used for embolization treatment of intracranial saccular aneurysm. Eight, intracranial wide neck aneurysm “reshaping” embolization, referred to as R-T embolization technology: intracranial wide neck aneurysm is a difficult problem of endovascular treatment, in order to prevent the spring coil of the embolized intracranial aneurysm from dislodging out of the wide neck of the aneurysm, occluding the aneurysm-carrying arteries or intracranial migratory embolism complications, in the course of the embolization, Moret inserted a non-removable balloon into the femoral artery via the contralateral femoral artery, and a tungsten coil was placed into the femoral artery to achieve the treatment purpose. During embolization, Moret delivered a non-detachable balloon catheter through the contralateral femoral artery to the neck of the intracranial wide-necked aneurysm, filled the balloon and temporarily blocked the opening of the neck of the aneurysm, and then embolized the aneurysm spring coils, which is a new technique. This method is mainly applicable to the embolization of “wide-necked” and irregularly shaped aneurysms. Nine, super-selective intra-arterial thrombolysis: it is a therapeutic method to insert microcatheter super-selectively into the internal carotid artery, intracranial segment of vertebral artery or its branches, and then inject thrombolytic drugs (e.g., urokinase, refined pit viper antacid enzyme, etc.) to dissolve cerebral thrombus or embolus within the cerebral vessels through the microcatheter. This technique is mainly used to treat acute cerebral thrombosis or cerebral embolism. X. Super-selective intra-arterial chemotherapy: It is a method of chemotherapy for malignant glioma by super-selectively inserting a microcatheter into the internal carotid artery above the ophthalmic artery or its branches, and injecting chemotherapeutic drugs (e.g., ACNU, BCNU) through the microcatheter. This technique is mainly used to treat malignant gliomas of the brain.