Endovascular Neurology

At South Texas Health System Clinics, we provide endovascular treatments for a full spectrum of cerebrovascular disease, including stroke, narrowing of blood vessels (stenosis), clots (thrombosis), blocked arteries (embolism), and ruptured blood vessels (hemorrhage).

Treatments We Offer

• Thrombectomy for acute stroke – For large blood clots, a thrombectomy is performed using a device called a stent retriever to remove the clot.
• Stenting of the carotid and vertebral arteries – A tiny balloon is temporarily inserted in the clogged artery and inflated to widen the area. A stent is then inserted to help decrease the chance of the artery clogging again.
• Embolization of cerebral aneurysms – Small metal coils are placed into an aneurysm to prevent it from rupturing by blocking the flow of blood.
• Embolization of arterio-venous malformations (AVMs) and fistulas – Abnormal connections between arteries and veins are filled by injecting liquid agents into the location where the artery and vein meet, stopping blood flow.
• Tumor embolization – The blood supply to a tumor is cut off to help shrink the tumor or slow its growth.
• Embolization for refractory epistaxis
• Treatment of cerebral sinus thrombosis
• Implantation of loop recorders for atrial fibrillation (Afib) detection – A device that records heart rate and rhythm and helps diagnose Afib.

Conditions We Treat

Stroke

The majority of strokes are caused by blood clots that form in the arteries of the neck or in the heart that then travel into the brain and block an artery there. As a result, brain tissue is deprived of oxygen and ultimately dies.

STHS Clinics offers help on two fronts: prevention and acute treatment.

Prevention

The heart condition that is responsible for most strokes is called atrial fibrillation (Afib). This condition often has no symptoms and therefore goes unnoticed and undiagnosed until it causes a stroke. We can identify patients at risk and implant a device (loop recorder) that records heart rate and rhythm and helps diagnose Afib. The appropriate medications prevent most strokes from occurring. The procedure typically lasts 10 minutes or less.

The carotid and vertebral arteries in the neck are often blocked with calcium in patients with risk factors such as smoking, hypertension (high blood pressure), and high cholesterol. We perform testing to diagnose the blockage and if needed we open up the artery with a procedure called stenting.

Treatment of Acute Stroke

Until 25 years ago there were no proven effective treatments for stroke. We now know how to intervene and improve patient outcomes. If a patient presents to the hospital within four hours from onset of symptoms, we can administer medications through the vein (thrombolytics) that can break up clots. If more than four hours have gone by or if the patient does not respond to the intravenous medication, we can perform an intervention called thrombectomy where we mechanically remove the clot from the blocked artery.

The cath lab where we perform interventions is located at STHS McAllen, a hospital that has been recognized as offering the highest level of stroke care (comprehensive stroke center).

Watch this interview with Dr. Alexandros Georgiadis, a board-certified neurologist with South Texas Health System Clinics and the Stroke Medical Director at STHS McAllen. Dr. Georgiadis discusses strokes, the symptoms, and how to prevent and treat them.

Symptoms of Stroke

As every second is critical to patient care, it is important to know the warning signs of a possible stroke:

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

If you or someone you know is having any of these symptoms, call 9-1-1 immediately.

Brain Hemorrhage (Bleeding Stroke)

Brain bleeds are caused by blood leaking through the arteries. In most cases this is caused by chronic hypertension. Maintaining normal blood pressure is the most important step in prevention.

However, in some cases the bleeding is caused by abnormalities in the arteries such as brain aneurysms and arterio-venous malformations (AVMs).

Brain Aneurysms

Aneurysms are outpouchings of the artery wall that form in adults and grow in size with time. The larger they become, the more likely they are to rupture and cause bleeding. The type of bleeding they cause is called subarachnoid hemorrhage and it carries very significant mortality and morbidity. We can identify and treat aneurysms with a procedure known as coil embolization. The aneurysms are filled with metal particles until blood can no longer enter. Bleeding is therefore no longer possible.

Arterio-Venous Malformations (AVMs)

AVMs consist of abnormal connections between veins and arteries that patients are born with. Over time, if left untreated, they can cause bleeding of the brain and seizures. We can diagnose and treat those lesions by injecting a glue-like substance into them.