Interventional neuroradiology

What 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.

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 service at King’s is one of the most established in the UK, participating in pivotal trials improving the treatment of cerebral aneurysms across the world. All procedures are performed using minimally invasive techniques, which means less pain, fewer complications, and shorter hospital stays.

The team is part of the neurosciences department and works closely with related specialties. This includes 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.

The King’s interventional neuroradiology training programme is one of the oldest schemes in the country and allows fellows to become proficient in all aspects of interventional neuroradiology. King’s College Hospital is a tertiary referral centre for complex aneurysms, brain and spinal arteriovenous malformations, dural arteriovenous fistula, and vascular malformations of the head and neck. The department performs 150 to 200 mechanical thrombectomies and 150 to 200 treatments of cerebral aneurysms every year. The department is actively involved in research and produces a number of high impact publications every year. Trainees will be expected to participate in research during their time in the department.

Preparing for your appointment

Check your appointment letter to see if you need to do anything to prepare for your appointment.

What to bring to your first outpatient appointment:

• your appointment letter
• a list of any medicines you are taking
• any samples your appointment letter asks you to bring
• money for prescriptions, or an exemption certificate
• a list of questions you want to ask

You will be seen by a specialist doctor. They will ask about your symptoms and your medical history and explain any tests you may need. They will also talk through with you what will happen next.

Visit the Brain and Spine Foundation website for more information and patient information leaflets on these conditions.

Please note: outpatients clinic appointments will take place in Suite 5 on the First Floor of the Golden Jubilee Wing at the hospital. Imaging and procedures will take place within the Neuroradiology Department at the location noted below. Please refer to the address noted on your appointment letter.

Location

Ground floor, Ruskin Wing, King’s College Hospital, Denmark Hill, London, SE5 9RS

Contact Details

• Main Reception: 020 3299 1583
• Outpatient Appointments: 020 3299 3282
• Pre-assessment Team: 020 3299 4433
• Specialist Nurses: 020 3299 7828
• Team Email: [email protected]