Neuroradiology and interventional neuroradiology

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ETMC uses less invasive techniques to treat neurological disorders

At ETMC, a team of neuroradiologists and interventional neuroradiologists use minimally invasive procedures to diagnose and treat a range of disorders involving the brain, head, neck and spine. Specializing in the growing field of endovascular medicine (procedures done through blood vessels), they provide treatments that make neurosurgery safer or eliminate the need for surgery altogether.

Conditions treated at ETMC using interventional neuroradiology

  • aneurysm, a weakened area in the wall of an artery
  • arteriovenous malformation (AVM), an abnormal tangle of blood vessels in the brain and spine
  • cavernoma, an abnormal cluster of tiny blood vessels that periodically bleed and lesions in the brain or spinal cord
  • carotid artery disease, a condition where the major vessels that supply blood to your brain become narrowed
  • carotid-cavernous fistula, an abnormal communication between the internal or external carotid arteries and the cavernous sinus due to lesions
  • dural arteriovenous fistula (DAVF), an abnormal connection of vessels in the tissues around the brain or spinal cord that can cause a number of problems
  • intracranial and extracranial atherosclerosis, the hardening and narrowing of the walls of the arteries inside the skull (intracranial) and outside the skull (extracranial)
  • nasal and sinus cavity disorders, including treatment for bleeding, blockages, lesions and tumors
  • spine compression fractures
  • stroke, which occurs when the blood supply to the brain is interrupted or severely reduced, depriving tissue of oxygen and nutrients
  • subarachnoid hemorrhage (SAH), caused when a brain aneurysm ruptures and bleeds into the compartment surrounding the brain, called the subarachnoid space
  • tumors and lesions of the head, neck and spine

Working closely with neurologists, neurosurgeons, oncologists, otolaryngologists (ENTs) and other specialists, the neuroradiology specialists at ETMC advance care and enhance life for thousands of East Texans each year.

content-neuro-refro“The interventional neuroradiologists are very important to us. They can actually go in and cut off the blood supply to certain types of tumors, which makes surgery to remove them much safer for the patient.”
Mark Renfro, MD, neurosurgeon

The latest technology allows for minimally invasive procedures

ETMC has invested in a dedicated interventional angiography suite equipped for endovascular management of a range of neurological disorders. This allows for minimally invasive procedures that increase safety and reduce recovery time.

Using 3-D image-guided techniques, our neuroradiology specialists deliver percutaneous therapies via needle-puncture of the skin, rather than through open surgery. This allows for biopsy and/or removal of lesions; precise positioning of coils, stents and other devices; and in the case of ischemic stroke, dissolving and removing clots to restore blood supply to the brain.

The Penumbra stroke system aids in removal of clots

The Penumbra stroke system used by interventional neuroradiologists at ETMC Tyler has dramatically broadened the treatment options for people with strokes caused by blood clots. Using a catheter and suction device to remove clots, this new endovascular tool can help restore brain blood flow for up to eight hours after the onset of symptoms.

Click here to see an animation of how it works, watch the Penumbra stroke system video.

Neuroradiology and interventional neuroradiology services at ETMC include

  • angiography, a diagnostic procedure that maps blood flow to the brain and body.
  • angioplasty, the dilation and opening of obstructed blood vessels, often followed by stent placement to keep the vessels open.
  • coiling, which involves the placement of thin metal wires that form coils inside a brain aneurysm to block blood flow and prevent rupture of the artery wall. An alternative treatment would be to place a clip on the vascular malformation to cut off blood supply.
  • embolization, a minimally invasive catheter treatment used to block blood flow to tumors, aneurysms and vascular malformations in the brain and spine.
  • intravascular therapy, for delivery of clot-busting drugs, chemotherapy and other treatments.
  • minimally invasive spine surgery, to treat spinal disorders such as fractures, tumors, compressed nerves and more.
  • percutaneous biopsy, a surgery-free method of removing tissue specimens for study.
  • stenting, a procedure to place a tiny metal scaffold (stent) in a narrowed artery to keep the vessel open for blood flow.
  • stroke management, including thrombolytic therapy (clot-busting medication) or Penumbra stroke system treatment for removal of clots during ischemic stroke events and coiling or clipping of the abnormal vessels in the case of hemorrhagic stroke.
  • vertebroplasty, a treatment for compression fractures of the spine that provides long-term pain relief and prevents further collapse of the vertebra.


“There are very few centers even in Dallas or Houston that have dedicated interventional neuroradiologists who can coil aneurysms, embolize AVMs and tumors, and do cutting-edge procedures for our patients.”
Thomas W. Grahm, MD, neurosurgeon