Endovascular Neurosurgery Program

What is endovascular neurosurgery?

Endovascular neurosurgery, also known as interventional neuroradiology, is a subspecialty of neurosurgery. Instead of traditional brain surgery, this minimally invasive approach can help doctors diagnose and treat brain conditions through the blood vessels.

About the Pediatric Endovascular Neurosurgery Program

Our Endovascular Neurosurgery Program is part of our larger Pediatric Neurosurgery Program, meaning your child benefits from closely coordinated care from specialists who work together to diagnose and treat complex neurovascular conditions.

Our team uses fluoroscopy, ultrasound and computed tomography (CT) to create highly detailed images of your child’s blood vessels. This process is called angiography. These images help guide catheters through your child’s body to evaluate vascular anatomy and identify conditions affecting the brain, head, neck and spine. Depending on your child’s condition, we can utilize smaller catheters, wires and devices to perform minimally invasive embolization treatments.

Why choose us for endovascular treatment

As a top-ranked pediatric hospital, Children’s Hospital Colorado specializes in caring for children’s unique medical needs. Our pediatric endovascular neurosurgery specialists are all board-certified, with advanced expertise in minimally invasive procedures for complex brain and vascular conditions. Your child’s care team also includes pediatric anesthesiologists, pediatric nurses, child life specialists and technologists certified by the American Registry of Radiologic Technologists.

Our advanced biplane angiography suite uses dual X-ray technology to capture real-time images, allowing us to provide precise diagnoses and treatment. Our procedures are all specifically designed for children, from the child-sized catheters, needles and devices we use to the medications we tailor to your child’s weight and size. We also use the lowest possible amounts of radiation to keep your child safe, and our child-adaptable scanning machines provide a more comfortable experience for children.

At Children’s Colorado, no one works alone. Our cross collaboration between teams is our strength. Our endovascular surgery team partners with internationally known specialists across Children’s Colorado to deliver fully coordinated care, including:

• Anesthesia
• Cardiology
• Developmental Pediatrics
• Interventional Radiology
• Neonatology
• Neurology
• Neuroradiology
• Neurosurgery
• Ophthalmology
• Otolaryngology

Renowned centers and programs

Our Vascular Anomalies Center is the only multidisciplinary clinic of its kind for infants, children and teenagers in the Rocky Mountain region. As one of the top programs in the country, we see and treat a wide range of vascular anomalies and complex cases, making us experts in endovascular neurologic conditions.

Our Retinoblastoma Program is dedicated to improving outcomes for one of the most common types of eye tumors in children. Our endovascular neurosurgery specialists partner with ophthalmologists to perform intra-arterial chemotherapy. This treatment is injected into the eye through the eye’s main blood vessel – limiting the amount of chemotherapy needed.

Together, we’re able to coordinate more comprehensive and effective care.

Endovascular conditions we diagnose, evaluate and treat

Our team specializes in diagnosing and managing a wide range of complex conditions including:

• Brain tumors
• Cavernous malformations
• Dural arteriovenous fistulas (DAVFs)
• Epilepsy
• Intracranial aneurysms
• Intracranial arteriovenous fistulas (AVFs)
• Intracranial arteriovenous malformations (AVMs)
• Ischemic Stroke thrombectomy
• Juvenile nasopharyngeal angiofibroma (JNA)
• Moyamoya syndrome
• Refractory epistaxis
• Retinoblastoma
• Seizures
• Vasculopathy
• Vasospasm
• Vein of Galen malformations (VOGM)

Endovascular treatments and services we provide

We offer a comprehensive range of minimally invasive endovascular procedures designed to treat complex neurological and vascular conditions with precision and reduced recovery times. These include:

• Endovascular embolization of dural AV fistulas
• Endovascular embolization of intracranial AVMs and pial AV fistulas
• Endovascular embolization of vein of Galen malformations
• Intracranial aneurysm coiling
• Intracranial aneurysm intrasaccular device placement for treatment
• Intracranial aneurysm stenting
• Ischemic stroke mechanical thrombectomy and thrombolysis
• Presurgical brain, head and neck tumor embolization
• Retinoblastoma chemoembolization
• Spinal dural AV fistula and AVM embolization
• Vasospasm treatment with balloon angioplasty and intra-arterial infusion

What to expect before, during and after an endovascular neurosurgery procedure

How to prepare for the procedure

Your child’s doctor will give you specific preparation guidelines based on the type of procedure we’re doing. Here are a few general tips to help your family get ready:

• Take time to talk with your child and explain the test.
• Reassure your child that they’ll be safe and comfortable and, in most cases, under general anesthesia.
• Bring a comfort item like a stuffed animal, toy or blanket.
• Bring a list of your child’s medicines and insurance card.

What to expect when you arrive for an endovascular neurosurgery procedure

When you arrive, we’ll give your child an identification bracelet to ensure they get the right test. A nurse will talk with you about the procedure and answer any questions. In some cases, you may meet with a child life specialist, who helps improve the care experience for kids.

Our anesthesiology team will talk with you about the anesthesia plan for the procedure. In most cases, we’ll use general anesthesia so your child can sleep through the procedure. You’re welcome to stay with your child in the pre-procedure exam room. When it’s time, we’ll bring your child to the procedure room and give them  general anesthesia to fall asleep.

What to expect during your child’s endovascular neurosurgery procedure

Endovascular neurosurgery typically follows these steps:

• A pediatric endovascular neurosurgeon places a small catheter in your child’s artery. We usually place this in the femoral artery, which is in the upper part of the leg or pelvis, but sometimes we place it in the radial artery, which is in the wrist.
• Your child will receive a contrast material through the catheter to help show better detail of the area of the body we’re studying.
• We use special cameras, X-ray equipment and scanners to take pictures of the arteries and veins inside your child’s body.
• Your care team will review the results and follow up with you on how they would like to proceed.

What to expect after a pediatric endovascular neurosurgery procedure

After the procedure is complete, our anesthesiologists will wake your child up and remove the breathing tube. Once this is done, we’ll bring your child to our post-operative care unit for recovery.

Your child will have activity restrictions after the procedure for 5 to 7 days because of the small hole that is used for the procedure. This provides adequate time for the hole to heal.  Your child’s care team will provide specific instructions on the day of the procedure.

If your child receives sedation or anesthesia, you’ll receive specific instructions from our anesthesia team. If your child receives a contrast material, the material will pass out of their body through their urine or stool. Your child should drink plenty of water to help flush it out.

Contact the Pediatric Endovascular Program

For appointments at any of our locations in the Denver Metro area, call 720-777-6100.

For appointments at Children’s Hospital Colorado, Colorado Springs, call 719-305-1234.