Stroke Prevention and Treatment
About Our Services
As active members in the medical community, AAR physicians are part of the Acute Stroke Progam at Inova Alexandria Hospital where they developed rapid response stroke protocols and played an instrumental role on the hospital team in achieving the Joint Commission’s Certificate of Distinction for Primary Stroke Centers. In 2009, HealthGrades awarded Inova Alexandria Hospital the Stroke Care Excellence Award and ranked the hospital among the top 10% in the nation for treatment of stroke and in the top 5% in the nation for women’s stroke services.
Carotid Artery Disease
Carotid artery disease, or CAD, is a condition in which the arteries that carry blood to the head and brain become narrowed or clogged. The most common cause of CAD is atherosclerosis (often called hardening of the arteries). Atherosclerosis is a gradual process in which cholesterol and scar tissue build up, forming a substance called “plaque” that clogs the blood vessels. The buildup of plaque is silent and generally asymptomatic. However, small particles of plaque can break off and travel to the smaller vessels in the brain, causing a stroke. The nature and severity of the symptoms depend on how large an area of the brain is affected. CAD is detected and monitored using either non-invasive techniques (magnetic resonance arteriography (MRA) or ultrasound examination) or angiography. When the degree of narrowing reaches a certain severity, treatment is warranted. Traditional therapy is a surgical procedure called carotid endarterectomy. In some instances, therapy with angioplasty or stent placement performed by the interventional radiologist may be indicated.
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| A stroke has blocked blood flow to a large section of the brain.
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After stroke therapy, blood flow to the brain is restored.
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Carotid Angiography
Angiography is an exam of the arteries and veins to diagnose blockages and other blood vessel problems. An interventional radiologist performs this procedure, also called an angiogram or venogram, on an out-patient basis. During the angiogram, the doctor inserts a thin tube (catheter) into the artery through a small incision in the skin. A substance called a contrast agent (X-ray dye) is injected to make the blood vessels visible on the X-ray. One of the most common reasons for angiography is to see if there is a blockage or narrowing in a blood vessel that may interfere with the normal flow of blood through the body. In many cases, the interventional radiologist can treat a blocked blood vessel without surgery at the same time the angiogram is performed using techniques called angioplasty and thrombolysis.
Stroke Thrombolysis
Thrombolytic therapy is an interventional technique that can open arteries and veins blocked by a blood clot. During angiography, the interventional radiologist identifies the exact location of the blood clot and injects thrombolytic (clot-busting) drugs directly into the clot to dissolve it and to restore blood flow. This treatment is often followed by angioplasty or stenting to hold open the treated section of artery or vein. This technique is usually used for treatment of arteries affected by PVD and for dissolving leg vein clots (deep venous thrombosis). Thrombolysis can also sometimes be used to treat patients who are having an acute (new) stroke, restoring blood flow to the brain before permanent brain damage occurs.