- Specialized expertise in treating many types of problems affecting your arteries and veins (vascular disorders), including acute ischemic stroke, cerebral aneurysms, arteriovenous malformation, dural arteriovenous fistula, carotid stenosis, and vascular tumors. Go to Conditions Treated
- Minimally invasive techniques to repair blood vessels (endovascular therapies) guided by imaging (X-rays or CT scans), without the need for open surgery. Go to Treatments
- Access to the newest treatment options and devices to control or cure vascular diseases, offered through clinical trials or after clinical trials have led to device approval. Go to Clinical Trials
- Team-based approach with specialized interventional radiologists, nurses, radiology technicians, and social workers working together to meet your needs. Go to Your Care Team
- Comprehensive support services including educational workshops, fitness classes, and support groups to maintain your quality of life. Go to Support Services
- Ease of access to treatment at our Neuroscience Health Center, a state-of-the-art facility that offers complete care at a convenient location. Go to Connecting to Care
At Stanford Health Care’s Neurointerventional Radiology Program, we offer expert diagnosis, treatment, and support for vascular disorders – problems that affect blood flow by impacting the arteries and veins (blood vessels) in your brain, head and neck, or spine. Our interventional neuroradiologists are part of a multispecialty team, including nurses, radiology technicians, social workers, and case managers, who work together to offer you the highest level of care.
We provide a comprehensive diagnostic evaluation and care for vascular disorders and related concerns, such as:
Acute stroke is a condition in which brain cells suddenly die because of a lack of oxygen. A stroke can be caused by a blockage in the blood flow to the brain (ischemic stroke) or the rupture of a blood vessel that feeds the brain (hemorrhagic stroke).
An aneurysm is an abnormal ballooning out of a blood vessel that carries oxygen-rich blood from the heart (artery). The wall of the artery weakens, putting you at risk of rupturing or bleeding from the aneurysm. This can lead to bleeding in the space surrounding the brain (subarachnoid hemorrhage) and can frequently cause hemorrhagic stroke.
Arteriovenous malformations (AVMs) are an abnormal set of connections between arteries and veins that usually occur in the brain and spine. AVMs can cause internal bleeding and neurologic symptoms such as headache, numbness, seizures, or weakness.
Carotid-cavernous fistula is an abnormal connection, such as a tunnel or hole, between blood vessels in the neck that carry oxygenated blood to the brain (carotid arteries) and the network of veins behind the eye (cavernous sinus). This connection raises pressure in the cavernous sinus and may compress and damage nerves going to the eye.
Carotid stenosis occurs when the carotid arteries become blocked or narrowed. This can cause temporary blockages of blood to the brain (transient ischemic attack, or TIA).
Dural arteriovenous fistulas (DAVF) are abnormal connections between arteries and veins that occur in the lining around the brain and spinal cord. DAVF may happen without an obvious cause, but can also be related to trauma, surgery, tumors, or previous infections.
Spinal compression fractures occur when the bones of the spinal column (vertebrae) break or collapse, often due to weakening from aging, disease, or certain medications.
Vascular tumors are growths made up of large numbers of blood vessels on the brain, spine, or head and neck region. They are typically noncancerous.
These rare types of AVM involve abnormal connections between the arteries in the brain and the vein of Galen, which transports blood from the brain to the heart. Vein of Galen malformations (VGAM) develop before birth, and doctors sometimes diagnose them in the womb or soon after birth.
Venous malformations (VM) are enlarged veins that are present at birth. When they grow, they may compress nerves or form clots. Lymphatic malformations (LM) are enlarged lymphatic vessels, part of your immune system that transports fluid into your bloodstream. This fluid may pool and lead to pain, infection, or bleeding.
Stanford Health Care's Neurointerventional Radiology team performs minimally invasive techniques using hollow plastic tubes (catheters) to treat vascular problems of the brain and spine from inside blood vessels. These procedures often eliminate the need for open surgery, shorten recovery times, and reduce hospital stays.
PROGRAM HIGHLIGHTS
- The Stanford Neurointerventional Radiology Program is one of the busiest neurointerventional programs in the West Coast. Each year, we perform over 250 neurointerventional procedures, 200 percutaneous procedures (using small incisions through the skin), and 600 diagnostic angiograms (X-rays that look at blood vessels).
- We’re one of the leading centers in the U.S. to participate in clinical studies, which have led to the widespread use of a number of endovascular techniques and devices. These include endovascular stroke devices approved for treatment of acute ischemic stroke, liquid embolic material used to treat brain AVMs and DAVFs, and endovascular coils for the treatment of aneurysms.
- The Stanford Health Care Comprehensive Stroke Center in Palo Alto was the first designated Comprehensive Certified Stroke Center in the U.S.
- Stanford Health Care uses special X-ray equipment designed for doing procedures in the head, neck, and spine. This equipment has a state-of-the-art 3D rotational imaging capability, which allows our doctors to precisely understand detailed vascular anatomy.
- Stanford Medicine doctors developed Cyberknife stereotactic radiosurgery, which uses radiation therapy to treat tumors and other vascular disorders. We have the most experienced Cyberknife team available in the world.
Testing
At Stanford Health Care, our experienced team thoroughly evaluates you, taking time to understand your symptoms and concerns. With the latest testing and imaging, we come up with an accurate diagnosis to start planning your treatment.
Our testing for vascular problems of the brain, head and neck, and spine includes:
Angiography/Arteriography gives us a better view of your blood vessels and how blood flows through them. We insert a small hollow tube (catheter) into an artery in your arm or leg. Through the catheter, we inject dye (contrast agent) into your arteries. Then we use X-rays to see the blood vessels.
Types of angiography we use include:
- Cerebral angiography, to see blood vessels in your head and neck
- CT angiography (CTA), which combines a CT scan with a dye injection
- Magnetic resonance angiography (MRA), which combines an MRI with a dye injection
Angiography can help diagnose:
- Acute stroke
- Aneurysm
- Arteriovenous malformations (AVM)
- Carotid cavernous fistula
- Dural arteriovenous fistulas (AVF)
- Vascular tumors
- Vein of Galen malformations (VGAM)
We may use this test to see whether it’s safe to block off a blood vessel while treating a condition such as aneurysm or vascular tumor. We temporarily block off blood flow by placing a catheter with a small balloon on the end into an artery to your brain. We gently inflate the balloon to block blood flow.
During this time, we monitor your neurological symptoms, such as memory, language, hand grip, and movement range of your feet. If you develop any problems, we immediately deflate the balloon and remove it. How you respond to this temporary blood flow blockage helps us figure out the best way to treat your vascular problem.
If we suspect an acute stroke, we’ll remove small blood samples to analyze. We may do the following blood tests:
- Blood clotting tests (coagulation panel), to see how fast your blood clots
- Blood sugar (glucose) levels, since low blood sugar may cause stroke-like symptoms
- Complete blood count, to check your blood levels of platelets, which help your blood to clot. We’ll also look for signs of low iron (anemia) and infection.
- C-reactive protein (CRP), to look for signs of inflammation caused by damage to your arteries
- Heart attack tests, to see whether you may have had a heart attack along with a stroke
- Serum electrolytes, to look at problems with your electrolytes (blood substances that carry an electrical charge). Disruptions to your electrolyte levels can cause stroke-like symptoms. This test also looks at whether you have kidney problems, which can affect stroke treatment.
- Thyroid tests, to see if you have hyperthyroidism, which can increase risk of atrial fibrillation and lead to stroke
Diagnostic imaging for vascular problems of the brain, head and neck, or spine can include:
- Bone density scan (DEXA scan) with vertebral fracture assessment (VFA): Uses low levels of X-rays to measure your bone density and look for spinal compression fractures
- Computed tomography (CT) scan: Uses specialized X-ray equipment to produce cross-sectional images of the brain, head, or spinal cord
- Echocardiogram: Uses sound waves to create pictures of your heart to check for clots related to acute stroke
- Electrocardiogram (EKG): Looks at your heart’s electrical activity to see whether a heart problem, such as atrial fibrillation, may have caused an acute stroke
- Magnetic resonance imaging (MRI): Uses radio waves and powerful magnets to create detailed images of the brain, head, or spinal cord
- Myelogram: Uses a contrast agent and CT or X-rays to look for problems with your spinal cord
- Ultrasound: Uses sound waves to create pictures of your blood vessels and tissues. A carotid ultrasound uses sound waves to see fatty deposits (plaque) and blood flow in the carotid arteries in your neck to check for acute stroke. A transcranial doppler ultrasound uses sound waves to look at blood flow in your brain.
- X-ray: Makes images of your spine to look for spinal compression fractures or other parts of your body to look for vascular tumors
We may use a lumbar puncture to test the fluid around your brain and spine (cerebrospinal fluid) to help diagnose an acute hemorrhagic stroke or ruptured aneurysm. We’ll use a needle to take cerebrospinal fluid from your back and test it for red blood cells, which may indicate an aneurysm or stroke.
Treatment Options
Our patients have access to the latest treatment options currently available. We use a multispecialty approach, offering the most effective minimally invasive treatments with the lowest risk after careful consideration and collaboration with Stanford Health Care’s Cerebrovascular Program and Comprehensive Stroke Center. Treatments you receive may include:
Carotid artery angioplasty with stenting (CSAS) is a minimally invasive procedure that can help blood flow in your arteries. We often use CSAS to treat carotid stenosis. During the procedure, we insert a small hollow tube (catheter) with an inflatable balloon at its tip from your groin to your carotid arteries. Then we inflate the balloon to open the artery and insert a thin metal tube (stent) to keep the artery open.
We use minimally invasive techniques to block off a blood vessel and stop blood supply to a certain area of your body. Embolization can treat:
- Acute stroke
- Aneurysm
- Arteriovenous malformations (AVM)
- Carotid cavernous fistula
- Dural arteriovenous fistulas (DAVF)
- Vascular tumors
- Vein of Galen malformations (VGAM)
- Venous and lymphatic malformations
During embolization, we insert a catheter through a tiny incision in your groin and direct it through your body to the area that needs repair. Then we use fine platinum coils, glue (liquid embolic material), foam, small plastic particles, or a balloon to cut off the blood supply to the area.
We use endovascular thrombectomy for the treatment of acute ischemic stroke. Endovascular thrombectomy uses catheters, tiny mesh devices that remove blood clots (stent retrievers), and other equipment to restore blood flow through blocked arteries in the neck or brain that are causing a stroke. Thrombectomy may be performed up to 24 hours after stroke symptoms begin in certain patients.
These minimally invasive treatments relieve pain due to spinal compression fractures. They also help to strengthen the bone from the inside. During a vertebroplasty or sacroplasty, we inject bone cement into cracked spinal bones. During kyphoplasty, we insert a balloon into the spinal bone and inflate the balloon to create more space. Then we deflate and remove the balloon before we inject the cement.
CyberKnife stereotactic radiosurgery is a noninvasive, robotic delivery system for radiation therapy. It uses real-time imaging to deliver the maximum safe dose of radiation from different angles directly to the target tissue to repair it. We may use radiosurgery to treat AVM, AVF, carotid-cavernous fistula, or vascular tumors.
We may use sclerotherapy to treat vascular anomalies, such as venous and lymphatic malformations. We use ultrasounds and X-rays to locate the vascular anomaly, and then inject a liquid medication (sclerosant) into the anomaly. This destroys blood vessels and leads to reduced or no blood flow through the vascular anomaly.
Stanford Health Care Neuroscience actively participates in groundbreaking research and clinical trials to evaluate new and better ways to diagnose, treat, and manage neurological disorders. Participating in a trial may give you access to experimental therapies that are not available otherwise. We also partner with the Wu Tsai Neurosciences Institute to better understand the brain, develop new treatments for brain disorders, and promote brain health.
Clinical Trials
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.
Open trials refer to studies that are currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
The Neurointerventional Radiology team is deeply committed to offering the best possible treatments available using minimally invasive techniques. Our interventional neuroradiologists are part of a multispecialty team, which also includes neurosurgeons, nurses, radiology technicians, social workers, case managers, and others. We are also dedicated to advancing the field of Neurointerventional Radiology through an active clinical research program.
Your Doctors
Neurointerventional Radiologist
Neurointerventional radiologist use minimally invasive procedures to diagnose and treat vascular conditions of the brain, head and neck, and spine. Neurointerventional Radiology is also called neurointerventional surgery.
View All 5 Neurointerventional Radiologists »Advanced Practice Providers (APPs)
Our skilled nurse practitioners specialize in caring for people with vascular disorders of the brain, head and neck, or spine. They see patients independently and occasionally alongside your doctor. APPs can give you a thorough exam, write prescriptions, and help prevent or treat any issues. Our APPs meet weekly to discuss patient needs.
View All {0} Advanced Practice Provider Doctors »Extended Care Team
Nurses and Nurse Coordinators (RNs)
Nurses and nurse coordinators are registered nurses who coordinate your care with your medical team. They guide you from your first contact through follow-up care and help you find counseling, financial, and other support services.
Care Coordinators
Care coordinators provide you with information and assistance before and during your appointment.
• Medical assistant: Medical assistants work with our team to help provide care. They may prepare you for an examination, assist your doctor, or take your vital signs before your appointment.
• Patient care coordinator: Our patient care coordinators help you schedule appointments and access your lab results. They are your first line of contact before you see your provider and will guide you during your care.
• Patient access representative: Patient access representatives can answer your questions about health insurance coverage, help you apply for health insurance, and refer you to our financial counselors.
Radiology Technologists
Radiology technologists perform medical imaging studies, including positioning patients for their exams and safely operating imaging equipment.
Social Workers
Our social workers educate families about supportive services, help patients access programs that enhance their independence and quality of life, and provide patients and families with supportive counseling and advocacy.
Case Managers
Our case managers are licensed nursing professionals responsible for coordinating patients’ continuum of care, overseeing the care process from admission through treatment through discharge.
Support Services
Your wellness is our top priority. As part of your care, we design a wellness plan to support you and your family before, during, and after treatment.
We offer a wide array of support services to help you to feel your best. Contact our Neuro Care Services for your personal support plan.
We strive to make access to care as simple as possible. We have a network of convenient locations across the Bay Area and a wide range of support services. User-friendly virtual health tools and video appointments help you stay connected with your care team from home. We accept most insurance plans and offer discounted transportation, short-stay options, and international travel and translation services. We make it easy for you to get the care you deserve. Our team guides you through each step, so you can make decisions that are right for you.
At the Stanford Health Care Neurointerventional Radiology Program, we make accessing care easy and convenient. We make every effort to coordinate your appointments so that you can see multiple providers, as needed, during a single visit.
For Referring Physicians
PHYSICIAN HELPLINE
Fax: 650-320-9443
Monday–Friday, 8 a.m.–5 p.m.
Stanford Health Care provides comprehensive services to refer and track patients, as well as the latest information and news for physicians and office staff. For help with all referral needs and questions, visit Referral Information.
You may also submit a web referral or complete a referral form and fax it to 650-320-9443 or email the Referral Center at ReferralCenter@stanfordhealthcare.org.
