Interventional Neuroradiology (INR)

What do we do?

Interventional neuroradiology is a medical specialty concerned with the treatment of certain diseases of the head, neck, brain, and spine, such as cerebral aneurysms, arteriovenous malformations and strokes. It is also known as endovascular neurosurgery, neurointerventional radiology or neurointervention.

The specialty includes the term ‘radiology’ in the title because guidance from X-rays and CT scans is used during procedures. Historically, these conditions required invasive open surgery. Advances now allow these diseases to be treated using ‘minimally invasive’ techniques. This allows for reduced complications and a faster recovery.

Interventional neuroradiologists (INRs) treat a wide range of diseases:

• brain aneurysm and subarachnoid haemorrhage with the use of coils, stents, and other devices
• stroke by retrieving blood clots from the brain, known as mechanical thrombectomy
• brain tumours using embolisation (depriving lesions of blood flow)
• head and neck tumours (such as paraganglioma) using embolisation
• brain and spine arteriovenous malformations and dural arteriovenous fistulas using embolisation
• carotid artery stenosis using balloons and stents
• intracranial vascular stenosis using balloons and stents
• intracranial hypertension and tinnitus with venous stents
• subdural haemorrhage treatment with middle meningeal artery embolisation
• nose bleeding (epistaxis) with embolisation
• vasospasm with chemical angioplasty

They also perform diagnostic procedures such as:

• cerebral angiography: evaluating the blood vessels of the brain using dye injected directly through the blood vessels
• myelography: diagnosis of conditions of the spine
• lumbar puncture: sampling fluid from the spine
• amytal test before resective surgery
• test occlusion before neurovascular occlusion

The team works closely with related specialties including neurosurgeons, neurologists, stroke physicians, intensive care specialists, and anaesthetists. Clinical nurse specialists provide psychosocial support and advice, particularly to patients recovering from aneurysmal subarachnoid haemorrhage.