Program details
Non-Surgical Stroke Treatment【Kishiwada Tokushukai Hospital】
surgery
Kishiwada Tokushukai Hospital（Kinki/Osaka）
Non-Surgical Stroke Treatment
Minimizing the Burden on the Body
Endovascular treatment for stroke without surgery is a minimally invasive method that reduces the burden on the body and enables faster recovery. Using catheters, brain blood vessels are treated safely from the inside, allowing for discharge within a short period.
- Genres
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- Department
- Disease
- Examination Items/Treatments/Surgical method
- Region/Organ
- Program Summary
- Non-Surgical Stroke Treatment (Endovascular Therapy)
What is Endovascular Therapy?
Endovascular therapy is a treatment method where a thin tube called a catheter is inserted remotely into the brain's blood vessels from the groin area under X-ray fluoroscopy. The procedure treats the blood vessels from the inside without requiring open-head surgery or direct manipulation of the brain. As a result, no scars are left, postoperative pain is absent, and patients typically only need half a day of rest. In the absence of complications, discharge is possible within a few days.
Narrowed blood vessels can be widened with a balloon catheter, and blocked vessels can be reopened. For ruptured blood vessels, the inside is sealed with coils or similar devices to prevent rebleeding.
The largest brain vessels are about 4 mm in diameter, and they become progressively narrower and more complex as they branch out. In some cases, catheters must be guided into vessels as narrow as 1 mm. Therefore, the catheters and guidewires used in endovascular therapy must be specifically designed with fine structures suitable for the brain's blood vessels, such as microcatheters and microguidewires.
Since the procedure involves remotely operating microcatheters under X-ray guidance from the groin, even slight movements of the patient's body can hinder the delicate manipulation required. Thus, endovascular therapy is performed in a catheterization suite under general anesthesia.
Currently, various tools have been developed for use within the brain's blood vessels, including coils of various shapes to seal brain aneurysms, balloons and stents to prevent coils from protruding, suction catheters, spring-shaped wires, and stents to remove blood clots (thrombi) from blocked vessels. Operating these delicate instruments within the brain's narrow vessels from the groin requires highly specialized and advanced technical skills.
Although non-surgical treatment significantly reduces the burden on the patient's body, it cannot be performed if the catheter cannot reach the affected area. Additionally, patients with impaired kidney function cannot undergo the procedure due to the use of contrast agents required for imaging during surgery. The introduction of foreign materials like catheters into blood vessels can also trigger thrombus formation.
Therefore, patients must take antiplatelet medications (blood-thinning drugs) before and after the procedure to prevent blood clots. If complications occur within the brain, they can lead to extremely severe symptoms. It is strongly recommended to consult and receive treatment at a facility with board-certified specialists and instructors in endovascular therapy.
- Medical Institutions
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Kishiwada Tokushukai Hospital
〒596-0042
4-27-1 Kamoricho, Kishiwada City
- Examination Items
- Setup Date
- Excluded days
- Required Days/Hours
- Start/end time
- Eligibility Criteria/Exclusions for Treatment
- Eligibility Criteria
1. Medical Information:
- Diagnosis (e.g., cerebral aneurysm, cerebral infarction, stroke)
- Detailed symptoms (e.g., headache, impaired consciousness, limb paralysis)
- Test results from other facilities (e.g., CT, MRI, angiography)
- Presence of comorbidities (e.g., diabetes, hypertension, kidney disease)
2. Treatment History:
- History of cerebrovascular treatments (e.g., catheterization, surgery)
- Current medications (e.g., anticoagulants, antiplatelet drugs)
- Allergies or adverse drug reactions
3. Age and Physical Condition:
- Confirmation of physical fitness for treatment in elderly patients or those with comorbidities
- Evaluation of eligibility for general anesthesia, including assessments of lung and cardiac function
4. Treatment Duration and Schedule:
- Treatment schedule (e.g., hospitalization period, post-treatment follow-up)
- Need for outpatient visits and follow-up monitoring
5. Kidney Function:
- Confirmation of adequate kidney function, as contrast agents may be required
6. Urgency:
- Determination of whether urgent intervention is needed for cases such as ruptured cerebral aneurysms or acute cerebral infarction
7. Other Conditions:
- Suitability for antiplatelet medication and management of pre-treatment drug regimens
- Precautions / Contraindications
- Precautions and Contraindications
1. Cases Not Suitable for Treatment:
- Severe renal dysfunction may make the use of contrast agents difficult, rendering the treatment contraindicated.
- Anatomical issues in the blood vessels or severe stenosis that make catheter insertion challenging.
- Patients for whom antiplatelet medication is contraindicated (e.g., those with extremely high bleeding risks) may face limited treatment options due to increased thrombotic risk.
2. Contraindications Related to General Anesthesia:
- Patients with reduced cardiopulmonary function or underlying conditions that prevent tolerance to general anesthesia.
- A history of drug allergies requires prior verification of medications to be used.
3. Risk of Complications:
- There is a risk of complications such as bleeding, thrombosis, or cerebral infarction during or after the procedure. Complications in the brain can result in severe symptoms.
- The introduction of foreign materials (e.g., catheters, stents) into blood vessels carries risks of infection and thrombosis.
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Pre-Procedure Instructions
1. Preoperative Preparation:
- Follow the doctor’s instructions regarding the discontinuation of antiplatelet or anticoagulant medications.
- Undergo all necessary preoperative tests, including blood tests, CT, MRI, and kidney function tests.
2. Postoperative Care and Risks:
- Postoperatively, there is a risk of bleeding, infection, and thrombosis; report any abnormalities to a medical institution immediately.
- Regular follow-up and monitoring during the postoperative period are essential; attend all scheduled outpatient visits.
3. Lifestyle Precautions:
- After treatment, there may be restrictions on physical activities and daily habits; follow the doctor’s advice and engage in activities within safe limits.
- Adopt a healthy lifestyle, including smoking cessation and a balanced diet, to manage the risk of arteriosclerosis.
4. Hospitalization and Follow-Up Schedule:
- Confirm the duration of hospitalization and the schedule for follow-up visits and postoperative monitoring in advance.
- Regular follow-up and examinations are required even after discharge.
5. Emergency Response:
- After discharge, if you experience symptoms such as headache, nausea, visual disturbances, or paralysis, contact a medical institution immediately.
- Ensure that you are aware of the contact information for emergency medical facilities and the attending physician in case urgent action is needed.
