OIA interventional radiologists perform a variety of non-invasive procedures that are ordered for diagnosis and/or therapeutic treatment of stroke and stroke-related disorders. These procedures are often life-saving and give patients an improved quality of life.

Fluoroscopy is normally used to guide the placement of the needle that delivers the pain medication or contrast material to the area of concern. The contrast material verifies accurate placement of the needle while the medication attempts to provide pain relief. In some instances, the procedure may be done in conjunction with another imaging modality such as MRI or CT to provide collaborating information.

Depending on the situation, the referring physician will make recommendations for the intervention that is appropriate. Whichever intervention is chosen, the main concern is to decrease the risk of a stroke or to stabilize an existing bleed to prevent further damage.

There are two types of strokes. In an ischemic stroke, the blood vessel is blocked by a clot. Ischemic strokes make up between 70-80 percent of all strokes. A hemorrhagic stoke occurs when a blood vessel ruptures. It is the most common type of stroke in young people and accounts for about 20 percent of all strokes.

The stroke intervention procedures listed below are performed by skilled OIA interventional radiologists. They usually take between 1 to 3 hours. In most cases, patients will be able to go home soon after the procedure.

Catheter Embolization
Endovascular Coiling/Intracranial Aneurysm Coiling or Coil Embolization
Thrombolytic Therapy
Stent Placement

Catheter Embolization

Catheter embolization is utilized to occlude (close) one or more blood vessels that are doing more harm than good. Various materials may be used, depending on whether vessel occlusion is to be temporary or permanent, or whether large or small vessels are being treated. The material is passed through a catheter with its tip lying in or near the vessel to be closed. This approach can be used to control or prevent abnormal bleeding as well as shut down the vessels that support a growing aneurysm or an arterial venous (AV) malformation.

Catheter Embolization Guidelines

When Your Procedure Is Scheduled

• Our scheduler will give you a date and time for your procedure at Overlake Hospital Medical Center. You will need to arrive at the hospital two hours before the procedure to allow the admitting and nursing staffs to get you ready.
  
• Please let the scheduler know if you take Coumadin, Plavix, Insulin or Metformin. You will need to receive specialized instructions.
  
• Please notify us if you’ve had a previous reaction to contrast dye.
  
• If you have any questions regarding your procedure, you may call us at 425-688-5507.
  
• The admitting department will attempt to call you the night before your procedure to confirm your arrival time.
  
• Please plan to leave any jewelry or valuables at home.
  
• Make sure to arrange for someone to drive you home after the procedure.

Preparation

• Do not eat or drink for four hours before your exam.
  
• Please take your normal heart and blood pressure medications with a sip of water.
  
• You need to be at the hospital’s admitting area two hours before you procedure’s scheduled start time. This is located at the large desk at the hospital’s main entrance (across from Stanza’s Café).
  
• You will be taken down to your room where you will meet your nurse. You will be asked to change into a patient gown. An IV will be started and blood drawn for lab tests. The nurse will ask you for your medical history. If possible, bring a list of all the medications you take and when you take them.
  
• The nurse will also ask you about allergies. If you are allergic to radiology/contrast dye please let them know.
  
• If there is a possibility that you’re pregnant, please let the nurse know. You will be asked to sign a form if you are a female of childbearing age (12-57).
  
• The nurse or tech will clean and shave an area on both sides of the groin for access to the femoral artery.
  
• Before the procedure, the interventional nurse will meet with you and your family to review the procedure and answer any questions you might have.

What to Expect During the Procedure

• The procedure takes from 1-3 hours. You will meet the interventional radiologist who will go over the consent form and answer any questions you might still have.
  
• You will receive sedation medication during the procedure to help you relax.
  
• During the procedure you might feel warmth, tingling or flushing when you are given the contrast dye. This usually lasts about 10 seconds. During the procedure the nurse will be monitoring your heart, blood pressure and the oxygen level in your blood.
  
• Once the procedure is over you will be transferred back to your room. You may have a small catheter still in place in the artery in your groin.

What to Expect After the Procedure

• The nurse or tech will remove the small catheter and hold pressure for at least 15 minutes. You will be told to lie flat for up to 6 hours and to keep your leg straight. This is to prevent any bleeding or swelling.
  
• Your blood pressure, pulse and puncture site will be monitored very frequently by the nurse.
  
• You will be encouraged to drink a lot of fluids to help wash the contrast out of your system. You will need to continue to drink fluids for the first 24 hours after your procedure, unless your physician has limited your fluid intake.
  
• You might be kept in the hospital for a 24-hour period for observation. Otherwise you will be discharged in 6-8 hours.
  
• You will be given written instructions and a phone number to call if you have any questions or concerns.
  
• One of the interventional nurses will do a follow-up call the next week-day after your discharge. Write down any questions you might have for them.
  
• To speak to an interventional nurse, please call 425-688-5005. It is best to call between 8AM and 4PM Monday thru Friday. You can leave a message on the voicemail, and a nurse will return your call as soon as possible.
  
• If you are on Coumadin and have been told not to take it before your procedure, you need to check with your physician, and/or the Anti-Coagulation Clinic for instructions.
  
• If you are on Metformin/Glucophage, withhold taking it for 48 hours post procedure. Check with the physician who ordered the medication on when to restart it. Additional blood work may be required.
  
• If you an insulin-dependent diabetic, restart your regular dosing when you get home. Check your sugar regularly and if you have a concern, contact your diabetic doctor.
  
• You may resume taking all of your normal medications once you are home.

Endovascular Coiling/Intracranial Aneurysm Coiling or Coil Embolization

Doctors treat aneurysms and arterial venous (AV) malformations by excluding them from the blood circulation, thereby eliminating the chance of rupture or hemorrhage. OIA interventional radiologists can "coil" the aneurysm or AV malformation by placing a catheter in the femoral artery (in the leg) and extending it up to the area of the problem in the brain. Fluoroscopy is used to see the exact location of the catheter at all times. The interventional radiologist places tiny platinum coils through the catheter into the aneurysm to prevent it from rupturing.

There are three types of detachable coils—bare platinum coils, coated platinum coils and biologically active coils. All three types are made of soft platinum wire of less than a hair's width.

A minimally invasive procedure, detachable coil embolization allows treatment of cerebral aneurysms that previously were considered inoperable. This procedure is less invasive and requires significantly less recovery time than surgery for aneurysm repair. Additional benefits include minimal blood loss and the option of local anesthesia.

The incidence of aneurysm recurrence depends on the coils' success or failure in controlling the "neck" of the aneurysm or fistula. If the coil completely prevents blood flow into the aneurysm, then the patient need not be concerned about recurrence. The durability of coil embolization varies depending on the size and shape of the aneurysm. Coil embolization of small aneurysms with small necks has better results than embolization of large or giant aneurysms with wide necks. Long-term follow-up has shown permanent success in more than 80 percent of aneurysms treated with coil embolization.

Endovascular Coiling/Intracranial Aneurysm Coiling or Coil Embolization Guidelines

When Your Procedure Is Scheduled

• Our scheduler will give you a date and time for your procedure at Overlake Hospital Medical Center. You will need to arrive at the hospital two hours before the procedure to allow the admitting and nursing staffs to get you ready.
  
• Please let the scheduler know if you take Coumadin, Plavix, Insulin or Metformin. You will need to receive specialized instructions.
  
• Please notify us if you’ve had a previous reaction to contrast dye.
  
• If you have any questions regarding your procedure, you may call us at 425-688-5507.
  
• The admitting department will attempt to call you the night before your procedure to confirm your arrival time.
  
• Please plan to leave any jewelry or valuables at home.
  
• Make sure to arrange for someone to drive you home after the procedure.

Preparation

• Do not eat or drink for four hours before your exam.
  
• Please take your normal heart and blood pressure medications with a sip of water.
  
• You need to be at the hospital’s admitting area two hours before you procedure’s scheduled start time. This is located at the large desk at the hospital’s main entrance (across from Stanza’s Café).
  
• You will be taken down to your room where you will meet your nurse. You will be asked to change into a patient gown. An IV will be started and blood drawn for lab tests. The nurse will ask you for your medical history. If possible, bring a list of all the medications you take and when you take them.
  
• The nurse will also ask you about allergies. If you are allergic to radiology/contrast dye please let them know.
  
• If there is a possibility that you’re pregnant, please let the nurse know. You will be asked to sign a form if you are a female of childbearing age (12-57).
  
• The nurse or tech will clean and shave an area on both sides of the groin for access to the femoral artery.
  
• Before the procedure, the interventional nurse will meet with you and your family to review the procedure and answer any questions you might have.

What to Expect During the Procedure

• The procedure takes from 1-4 hours. You will meet the interventional radiologist who will go over the consent form and answer any questions you might still have.
  
• You will receive sedation medication during the procedure to help you relax.
  
• During the procedure you might feel warmth, tingling or flushing when you are given the contrast dye. This usually lasts about 10 seconds. During the procedure the nurse will be monitoring your heart, blood pressure and the oxygen level in your blood.
  
• Once the procedure is over you will be transferred to the ICU. You may have a small catheter still in place in the artery in your groin.

What to Expect After the Procedure

• The nurse or tech will remove the small catheter and hold pressure for at least 15 minutes. You will be told to lie flat for up to 6 hours and to keep your leg straight. This is to prevent any bleeding or swelling.
  
• Your blood pressure, pulse and puncture site will be monitored very frequently by the nurse.
  
• You will be encouraged to drink a lot of fluids to help wash the contrast out of your system. You will need to continue to drink fluids for the first 24 hours after your procedure, unless your physician has limited your fluid intake.
  
• If your aneurysm has not ruptured prior to coiling, you will generally spend one night in the intensive care unit for monitoring and then another night in the hospital.
  
• You will be given written instructions and a phone number to call if you have any questions or concerns.
  
• One of the interventional nurses will do a follow-up call the next week-day after your discharge. Write down any questions you might have for them.
  
• To speak to an interventional nurse, please call 425-688-5005. It is best to call between 8AM and 4PM Monday thru Friday. You can leave a message on the voicemail, and a nurse will return your call as soon as possible.
  
• If you are on Coumadin and have been told not to take it before your procedure, you need to check with your physician, and/or the Anti-Coagulation Clinic for instructions prior to resuming it.
  
• If you are on Metformin/Glucophage, withhold taking it for 48 hours post procedure. Check with the physician who ordered the medication on when to restart it. Additional blood work may be required.
  
• If you an insulin-dependent diabetic, restart your regular dosing when you get home. Check your sugar regularly and if you have a concern, contact your diabetic doctor.
  
• You may resume taking all of your normal medications once you are home.

Thrombolytic Therapy

This treatment is used to treat strokes caused by blood clots. If clots are blocking blood vessels, interventional radiologists can use a catheter to inject drugs directly into the clot to dissolve it and restore blood flow. These "clot busters" dissolve the clot and restore blood flow.

Thrombolytic Therapy Guidelines

When Your Procedure Is Scheduled

• Our scheduler will give you a date and time for your procedure at Overlake Hospital Medical Center. You will need to arrive at the hospital two hours before the procedure to allow the admitting and nursing staffs to get you ready.
  
• Please let the scheduler know if you take Coumadin, Plavix, Insulin or Metformin. You will need to receive specialized instructions.
  
• Please notify us if you’ve had a previous reaction to contrast dye.
  
• If you have any questions regarding your procedure, you may call us at 425-688-5507.
  
• The admitting department will attempt to call you the night before your procedure to confirm your arrival time.
  
• Please plan to leave any jewelry or valuables at home.
  
• Make sure to arrange for someone to drive you home after the procedure.

Preparation

• Do not eat or drink for four hours before your exam.
  
• Please take your normal heart and blood pressure medications with a sip of water.
  
• You need to be at the hospital’s admitting area two hours before you procedure’s scheduled start time. This is located at the large desk at the hospital’s main entrance (across from Stanza’s Café).
  
• You will be taken down to your room where you will meet your nurse. You will be asked to change into a patient gown. An IV will be started and blood drawn for lab tests. The nurse will ask you for your medical history. If possible, bring a list of all the medications you take and when you take them.
  
• The nurse will also ask you about allergies. If you are allergic to radiology/contrast dye please let them know.
  
• If there is a possibility that you’re pregnant, please let the nurse know. You will be asked to sign a form if you are a female of childbearing age (12-57).
  
• The nurse or tech will clean and shave an area on both sides of the groin for access to the femoral artery.
  
• Before the procedure, the interventional nurse will meet with you and your family to review the procedure and answer any questions you might have.

What to Expect During the Procedure

• The procedure takes from 1-3 hours. You will meet the interventional radiologist who will go over the consent form and answer any questions you might still have.
  
• You will receive sedation medication during the procedure to help you relax.
  
• During the procedure you might feel warmth, tingling or flushing when you are given the contrast dye. This usually lasts about 10 seconds. During the procedure the nurse will be monitoring your heart, blood pressure and the oxygen level in your blood.
  
• Once the procedure is over you will be transferred back to your room. You may have a small catheter still in place in the artery in your groin.

What to Expect After the Procedure

• The nurse or tech will remove the small catheter and hold pressure for at least 15 minutes. You will be told to lie flat for up to 6 hours and to keep your leg straight. This is to prevent any bleeding or swelling.
  
• Your blood pressure, pulse and puncture site will be monitored very frequently by the nurse.
  
• You will be encouraged to drink a lot of fluids to help wash the contrast out of your system. You will need to continue to drink fluids for the first 24 hours after your procedure, unless your physician has limited your fluid intake.
  
• You will be kept in the hospital’s ICU for a 24-hour period for observation. Some patients may require an additional Otherwise you will be discharged in 6-8 hours.
  
• You will be given written instructions and a phone number to call if you have any questions or concerns.
  
• One of the interventional nurses will do a follow-up call the next week-day after your discharge. Write down any questions you might have for them.
  
• To speak to an interventional nurse, please call 425-688-5005. It is best to call between 8AM and 4PM Monday thru Friday. You can leave a message on the voicemail, and a nurse will return your call as soon as possible.
  
• If you are on Coumadin and have been told not to take it before your procedure, you need to check with your physician, and/or the Anti-Coagulation Clinic for instructions.
  
• If you are on Metformin/Glucophage, withhold taking it for 48 hours post procedure. Check with the physician who ordered the medication on when to restart it. Additional blood work may be required.
  
• If you an insulin-dependent diabetic, restart your regular dosing when you get home. Check your sugar regularly and if you have a concern, contact your diabetic doctor.
  
• You may resume taking all of your normal medications once you are home.