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Neuroradiology Patient Education |
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Departments & Services > Radiology > Patient Information > Neuroradiology Patient Education |
Welcome
to the Information Resource Page for the division of Neuroradiology at
Fletcher Allen Health Care in Burlington Vermont. Statement of Purpose:
Below are some facts regarding a number of procedures we perform in our department.
Cerebral
Angiogram What Should I Do To Get Ready? Please let us know if you have any allergies, especially to iodine or shellfish. The morning of the test you should not have anything to eat or drink. Clear liquids should be stopped at the time you are to report to registration. You may take your oral medications with sips of water unless your doctor or nurse has told you otherwise. Please inform your doctor if you are taking any oral diabetic medications (i.e. Glucophage). Before You will register at the Main Medical Center Campus on Colchester Avenue. You will be directed to the Radiology Department located on McClure 1. You will give your name to the Radiology Secretaries and be directed to the radiology waiting room. You will be greeted by the Angiography Nurse and be escorted to the pre-procedure area. You will be asked to change into a hospital gown. An IV will be started in your arm to provide fluids and a Neuroradiologist or Nurse Practitioner will go over details of the angiogram with you and answer any questions you may have. In the x-ray room you will lie on a moveable table and be covered with sterile sheets. The groin area, just above your leg, at the inner thigh, will first be shaved and cleansed with a liquid. Then an anesthetic will be injected to numb that site before the catheter is placed.
During the test, you will need to lie very still to achieve the best results. Medication may be given through the IV to ensure comfort and relaxation. As the catheter is guided through your vessels, the pathway will be checked by x-rays. Once it is in place, there will be several injections of dye. You will have a warm feeling on the side of neck and face, lasting 30-60 seconds. The doctors and staff step out of the room for a short time while the x-rays are being taken. At any time during the test, if you feel uncomfortable or short of breath, tell your doctor. After Once the angiogram is done, the catheter will be removed and firm pressure or a closure device may used on that area for about 15 minutes to prevent bleeding. You will then be taken to Baird 3 where you will stay for the next 6 hours. During that time, you will need to keep your leg straight. You may roll side to side. A nurse will check your blood pressure, pulse and the site where the catheter was. You will also be asked to drink plenty of fluids to help flush the dye from your system. At the end of that time, when you feel able, and after you have been walking with help, you can be discharged to home. Keep in mind you must have someone here to drive you home. At Home Drink 10-20 glasses of fluid the first 24 hours after the procedure. If unresolved bleeding occurs at the catheter site, apply direct pressure and be driven to the nearest ER. You should not drink any alcohol during this time. When To Call The Doctor?
Phone Numbers For
follow-up help, call the hospital paging operator (802) 847-2700. Ask
to speak to the neuroradiologist on call. Give the operator your name
and phone number with area code. The doctor will call you back.
What Is It? An aneurysm coiling is performed in the angiography suite with a catheter similar to that used during your angiogram/arteriogram. Through the catheter, the aneurysm is packed with material that does not allow arterial blood to flow into it. This technique is called embolization. The materials used for the aneurysm embolization include platinum coils. Who Will Perform This Procedure? Interventional Neuroradiologists (INR) perform these types of procedures. These physicians have completed specialized training using x-rays to guide catheters within the blood vessels. These INRs embrace the treatment of neurological diseases with neuroendovascular techniques. This includes the delivery of balloons, particles, coils, and stents within the blood vessels that nourish the brain. Will I Get Medication to Relax During The Procedure? The INR is placing very small catheters to the site of the aneurysm, which requires a patient to be absolutely still; therefore general anesthesia is preferred. How Do I Know This Procedure Is Suitable For Me? The team of physicians, Interventional Neuroradiologists, Vascular Neurologists, Vascular Neurosurgeons, work together to make the most accurate diagnosis and care plan based on your disease. If they believe your aneurysm may be treated using an endovascular technique our office will be contacted. Subsequently, our Clinical Office Assistant (COA) will contact you for an initial consultation with INR and the Nurse Practitioner (NP). What Should I Expect The Day Of The Consultation? The day of your consultation you will register at the Main Medical Center on Colchester Avenue. You will be directed to the Radiology Department on the first floor located on McClure 1. You will give your name to the Radiology Secretaries and be directed to the radiology waiting room. You will be greeted by the NP and be escorted to the Invasive Procedure Clinic (IPC) where the consultation will take place. An explanation of the procedure, the risks and benefits identified, a medical history will be collected and a physical examination will be completed. This consultation also provides you with the opportunity to ask the INR any questions you may have. The results of the consultation will be discussed with your referring provider. If I Decide To Have This Aneurysm Coiling Procedure, What Should I Do To Get Ready? Before The IPC staff will make the necessary arrangements for you to be prepared the day of your procedure. You will need a complete history and physical within 30 days of your procedure and blood studies within 14 days. An electrocardiogram and/or x-ray of your chest may be required for your procedure. The NP will discuss your individual plan with you and will make the necessary arrangements for the requirements to be completed and reviewed prior to the procedure. After these studies are completed, the anesthesiologist will need to review your medical history with you. This may be completed by an on-site visit or by telephone. This individual will instruct you when to stop eating and drinking, discuss medication matters, and notify you as to what time to report to registration. Day Of The Procedure You will register at the Main Medical Center Campus on Colchester Avenue. You will be directed to the Radiology Department on McClure 1. The secretaries will direct you to the radiology waiting room. The preprocedure nurse will take you to designated pre-operative area where you will be asked to change into a hospital gown. At this time your family/friends will be directed to the Surgical Waiting Area. An IV will be started in your arm to provide fluids. The INR may obtain your consent for the procedure at this time if it had not been done prior. This also applies to the Anesthesiologist’s obtaining consent for the anesthesia. You will be taken to the angiography suite for the procedure. Once you arrive to the suite a small tube will be placed in your bladder and your groin area, just above your leg, at the inner thigh, will be shaved and cleansed with a liquid. As the procedure begins, the anesthesiologist will give you medication to ensure your comfort and relaxation. Your procedure will take several hours. Your family/friends will be notified of the completion. After After the procedure is completed, you will be taken to the Post Anesthesia Care Unit (PACU) for several hours and then to the Intensive Care Unit (ICU), lying flat on your back for up to six hours. This rest period allows the artery in your groin to heal. You will be admitted to the Neurosurgery or Neurological service for close observation for a day or two. The number of days will vary depending on your condition. During your hospital stay, Neurologists, Neurosurgeons, and Interventional Neuroradiologists and other medical staff may see you. Prior to your discharge, you will be given written instructions regarding your activity level, diet, medications and follow- up appointments. The INR will expect to see you one to two weeks following the procedure. This may be arranged prior to your discharge.
In
collaboration with the referring physician, the INR may recommend particular
medications or studies to be done in the weeks or months to follow. The
INR will discuss your plan of care with you at your follow- up clinic
visit. Embolization of Arteriovenous Malformation What Is It? An arteriovenous malformation (AVM) is a tangle of abnormally connecting arteries and veins. An embolization of an AVM involves the blocking off the blood supply that flows through the malformation. This is performed in the angiography suite with a catheter similar to that used during your angiogram/arteriogram. Through the catheter, the malformation is occluded with material that does not allow blood to flow into it. This technique is an embolization. The materials used for the malformation embolization include coils, glue and/or synthetic particles (embospheres). This procedure can be done in conjunction with other therapies, for example radiosurgery. Who Will Perform This Procedure? Interventional Neuroradiologists (INR) perform these types of procedures. These physicians have completed specialized training using x-rays to guide catheters within the blood vessels. These INRs embrace the treatment of neurological diseases with neuroendovascular techniques. This includes the delivery of balloons, particles, coils, and stents within the blood vessels that nourish the brain. Will I Get Medication to Relax During The Procedure? The INR is placing very small catheters to the site of the malformation, which requires a patient to be absolutely still; therefore general anesthesia is preferred. How Do I Know This Procedure Is Suitable For Me? The team of physicians, Interventional Neuroradiologists, Vascular Neurologists, Vascular Neurosurgeons, work together to make the most accurate diagnosis and care plan based on your disease. If they believe your aneurysm may be treated using an endovascular technique our office will be contacted. Subsequently, our Clinical Office Assistant (COA) will contact you for an initial consultation with INR and the Nurse Practitioner (NP). What Should I Expect The Day Of The Consultation? The day of your consultation you will register at the Main Medical Center on Colchester Avenue. You will be directed to the Radiology Department on the first floor located on McClure 1. You will give your name to the Radiology Secretaries and be directed to the radiology waiting room. You will be greeted by the NP and be escorted to the Invasive Procedure Clinic (IPC) where the consultation will take place. An explanation of the procedure, the risks and benefits identified, a medical history will be collected and a physical examination will be completed. This consultation also provides you with the opportunity to ask the INR any questions you may have. The results of the consultation will be discussed with your referring provider. If I Decide To Have This Aneurysm Coiling Procedure, What Should I Do To Get Ready? Before The IPC staff will make the necessary arrangements for you to be prepared the day of your procedure. You will need a complete history and physical within 30 days of your procedure and blood studies within 14 days. An electrocardiogram and/or x-ray of your chest may be required for your procedure. The NP will discuss your individual plan with you and will make the necessary arrangements for the requirements to be completed and reviewed prior to the procedure. After these studies are completed, the anesthesiologist will need to review your medical history with you. This may be completed by an on-site visit or by telephone. This individual will instruct you when to stop eating and drinking, discuss medication matters, and notify you as to what time to report to registration. Day Of The Procedure You will register at the Main Medical Center Campus on Colchester Avenue. You will be directed to the Radiolgy Department on McClure 1. The secretaries will direct you to the radiology waiting room. The preprocedure nurse will take you to the designate preoperative area where you will be asked to change into a hospital gown. An IV will be started in your arm to provide fluids. The INR may obtain your consent for the procedure at this time if it had not been done prior. This also applies to the Anesthesiologist’s obtaining consent for the anesthesia. You will be taken to the angiography suite for the procedure. At this time your family/friends will be directed to the Surgical Waiting Area. Once you arrive to the suite a small tube will be placed in your bladder and your groin area, just above your leg, at the inner thigh, will be shaved and cleansed with a liquid. As the procedure begins, the anesthesiologist will give you medication to ensure your comfort and relaxation. Your procedure will take several hours. Your family/friends will be notified of the completion. After After the procedure is completed, you will be taken to the Post Anesthesia Care Unit (PACU) for several hours and then to the Intensive Care Unit (ICU), lying flat on your back for up to eight hours. This rest period allows the artery in your groin to heal. You will be admitted to the Neurosurgery or Neurological service for close observation for a day or two. The number of days will vary depending on your condition. During your hospital stay, Neurologists, Neurosurgeons, and Interventional Neuroradiologists and other medical staff may see you. Prior to your discharge, you will be given written instructions regarding your activity level, diet, medications and follow- up appointments. The INR will expect to see you one to two weeks following the procedure. This may be arranged prior to your discharge.
In collaboration with the referring physician, the INR may recommend particular medications or studies to be done in the weeks or months to follow. The INR will discuss your plan of care with you at your follow- up clinic visit.
Carotid
Stent Placement The placement of a carotid stent is performed in the angiography suite with a catheter similar to that used during your angiogram/arteriogram. A small tube is threaded up from the groin and once in the carotid artery, a small metal pipe or stent, is positioned at the site of the narrowing. This stent is expanded and opens up the narrowing in the carotid artery to allow arterial blood to flow through it. Who Will Perform This Procedure? Interventional Neuroradiologists (INR) perform these types of procedures. These physicians have completed specialized training using x-rays to guide catheters within the blood vessels of the central nervous system. These INRs embrace the treatment of neurological diseases with neuroendovascular techniques. This includes the delivery of balloons, particles, coils, and stents within the blood vessels that nourish the brain. This stent is not yet an FDA approved use but it is widely used in various cases, such as patients with high bifurcation stenosis (narrowing) or those with carotid stenosis as a result of radiation therapy.
The INR is placing very small catheters to the site of the narrowing, which requires a patient to be absolutely still; therefore general anesthesia is preferred. How Do I Know This Procedure Is Suitable For Me? The team of physicians, Interventional Neuroradiologists, Vascular Neurologists, Vascular Neurosurgeons, work together to make the most accurate diagnosis and care plan based on your disease. There are certain features of stenosis (narrowing), for example the size of the artery or the location of the blockage, or certain medical conditions in your history that may necessitate this approach. If they believe your carotid artery stenosis may be treated using an endovascular technique our office will be contacted. Subsequently, our Clinical Office Assistant (COA) will contact you for an initial consultation with INR and the Nurse Practitioner (NP). What Should I Expect The Day Of The Consultation? The day of your consultation you will register at the Main Medical Center on Colchester Avenue. You will be directed to the Radiology Department on the first floor located on McClure 1. You will give your name to the Radiology Secretaries and be directed to the radiology waiting room. You will be greeted by the NP and be escorted to the Invasive Procedure Clinic (IPC) where the consultation will take place. An explanation of the procedure, the risks and benefits identified, a medical history will be collected and a physical examination will be completed. This consultation also provides you with the opportunity to ask the INR any questions you may have. The results of the consultation will be discussed with your referring provider. If I Decide To Have This Aneurysm Coiling Procedure, What Should I Do To Get Ready? Before The IPC staff will make the necessary arrangements for you to be prepared the day of your procedure. You will need a complete history and physical within 30 days of your procedure and blood studies within 14 days. An electrocardiogram and/or x-ray of your chest may be required for your procedure. After these studies are completed, the anesthesiologist will need to review your medical history with you. This may be completed by an on-site visit or by telephone. This individual will instruct you when to stop eating and drinking, discuss medication matters, and notify you as to what time to report to registration. The NP will discuss your individual plan with you and will make the necessary arrangements for the requirements to be completed and reviewed prior to the procedure. The NP will give you a prescription for 3, Plavix (Clopidogrel) 75 mg tablets. One of these pills will be taken for 3 consecutive days prior to your procedure. Your 3rd pill will be taken the am of your procedure. This will keep your blood thin for the procedure. You will continue this medication after the procedure. Detail instructions will be provided at the time your are discharged. Please notify the NP if you are allergic to this medication and other arrangements will be made. Day Of The Procedure You will register at the Main Medical Center Campus on Colchester Avenue. You will be directed to the Radiology Department on McClure 1. The secretaries will direct you to the radiology waiting room. The preprocedure nurse will take you to the designated pre-operative area where you will be asked to change into a hospital gown. An IV will be started in your arm to provide fluids. The INR may obtain your consent for the procedure at this time if it had not been done prior. This also applies to the Anesthesiologist’s obtaining consent for the anesthesia. You will be taken to the angiography suite for the procedure. At this time your family/friends will be directed to the Surgical Waiting Area. Once you arrive to the suite a small tube will be placed in your bladder and your groin area, just above your leg, at the inner thigh, will be shaved and cleansed with a liquid. As the procedure begins, the anesthesiologist will give you medication to ensure your comfort and relaxation. Your procedure will take several hours. Your family/friends will be notified of the completion. After After the procedure is completed, you will be taken to the Post Anesthesia Care Unit (PACU) for several hours and then to the Intensive Care Unit (ICU), lying flat on your back for up to six hours. This rest period allows the artery in your groin to heal. You will be admitted to the Neurosurgery or Neurological service for close observation for a day or two. The number of days will vary depending on your condition. During your hospital stay, Neurologists, Neurosurgeons, and Interventional Neuroradiologists and other medical staff may see you. Prior to your discharge, you will be given written instructions regarding your activity level, diet, medications and follow- up appointments. The INR will expect to see you one to two weeks following the procedure. This may be arranged prior to your discharge.
In collaboration with the referring physician, the INR may recommend particular medications or studies to be done in the weeks or months to follow. The INR will discuss your plan of care with you at your follow- up clinic visit.
What Is It? A vertebroplasty procedure is a treatment for fractures of the vertebrae. The most common condition causing these fractures is osteoporosis. This is a condition in which the bones become thin and fragile. A simple twist or strain can result in a bone fracture in a patient with osteoporosis. Vertebroplasty is a potential treatment for these fractures. This procedure is performed in the angiography suite, allowing the physician to use x-ray while inserting needles through the skin and into the fractured (“crushed”) vertebrae. A cement is injected into the bone to stabilize the vertebrae. Who Will Perform This Procedure? Interventional Neuroradiologists (INR) perform these types of procedures. These physicians have completed specialized training using x-rays to perform minimally invasive procedures, such as vertebroplasty. Will I Get Medication to Relax During The Procedure? The INR is placing needles into the vertebrae, which requires a patient to be still; therefore conscious sedation is administered through an IV by the radiology nursing staff. This medication is to ensure comfort and relaxation. The INR will also use local numbing medicine at the insertion site. It is critical you report any allergies. How Do I Know This Procedure Is Suitable For Me? The team of physicians, Interventional Neuroradiologists, the Spine Specialists and your referring provider work together to make the most accurate diagnosis and care plan based on your disease. If they believe your spinal fracture may be treated with vertebroplasty our office will be contacted. Subsequently, our Clinical Office Assistant (COA) will contact you for an initial consultation with INR and the Nurse Practitioner (NP). It is possible, our team will arrange for further imaging of the spine. There are certain studies required, for example a CT scan or MRI, to proceed with the consideration for this particular procedure. This is decided on an individual basis. What Should I Expect The Day Of The Consultation? The day of your consultation you will register at the Main Medical Center on Colchester Avenue. You will be directed to the Radiology Department on the first floor located on McClure 1. You will give your name to the Radiology Secretaries and be directed to the radiology waiting room. You will be greeted by the NP and be escorted to the Invasive Procedure Clinic (IPC) where the consultation will take place. An explanation of the procedure, the risks and benefits identified, a medical history will be collected and a physical examination will be completed. This consultation also provides you with the opportunity to ask the INR any questions you may have. The results of the consultation will be discussed with your referring provider. If It Is Decided I Am An Appropriate Candidate For A Vertebroplasty, What Should I Do To Get Ready? Before The IPC staff will make the necessary arrangements for you to be prepared the day of your procedure. You will need blood studies within 14 days. The NP will discuss your individual plan with you and will make the necessary arrangements for the requirements to be completed and reviewed prior to the procedure. The pre-procedure nurse will contact you the day before the scheduled procedure. She will instruct you when to stop eating and drinking, discuss medication matters, and notify you as to what time to report to registration. Day Of The Procedure You will register at the Main Medical Center Campus on Colchester Avenue. You will be directed to the Radiology Department on McClure 1. The secretaries will direct you to the radiology waiting area. You will be greeted by the pre-procedure nurse and escorted to the pre-procedure holding area where you will be asked to change into a hospital gown. An IV will be started in your arm to provide fluids. The INR or NP will obtain your consent for the procedure and for the sedation. You will be taken to the angiography suite for the procedure. Once you arrive to the suite your back will be cleansed with a liquid by the technologist. As the procedure begins, the radiology nurse will give you the sedative. Your procedure will take approximately 1 ½ hours. Your family/friends will be notified of the completion. After After the procedure is completed, you will be taken to the recovery floor on Baird 3. You will required to lie flat for 2 hours after the procedure. This will ensure the cement has ample time to dry properly. The recovery nurses will monitor your vital signs, the wound and your activity tolerance. You will be asked to walk in the hallway prior to your discharge. You are required to have someone available to drive you home. Prior to your discharge, you will be given written instructions regarding your activity level, diet, medications and follow- up appointments. The INR will expect to see you one week following the procedure or arrangements will be made for a follow-up telephone call. This may be arranged prior to your discharge.
There are individuals who feel immediate relief of their symptoms following the procedures others report improvement within 48 hours. Many people can resume normal activities within days, however people often will OVERDUE it because they feel well. Our recommendations are to gradually increase your activity level. Remember a simple movement is likely what caused the initial fracture. Vertebroplasty is a treatment for that fracture not for the underlying osteoporosis. |
