Endovascular neurosurgery treats vessel problems of the brain and spine from inside the blood vessel, using thin catheters guided through an artery, usually at the groin or wrist. It avoids opening the skull in many cases and is used for aneurysms, vascular malformations, narrowed arteries and, in selected patients, acute stroke caused by a large clot.

Planning begins with imaging that shows the vessel anatomy, followed by a diagnostic cerebral angiogram, which uses X-ray and contrast dye to produce a detailed map. Based on these findings, the team decides whether a catheter-based approach is possible and safe. Some lesions are better treated by open surgery, and the choice is made together with the patient and family.

After treatment, patients are monitored closely, often in an intensive care or high-dependency setting, and medicines to prevent clotting may be needed for a period.

Endovascular services at Apex include:

• Diagnostic Cerebral Angiography: A catheter-based X-ray study of the brain's blood vessels, used to identify aneurysms, malformations and blockages and to plan treatment.
• Aneurysm Coiling: Filling of an aneurysm with fine platinum coils delivered through a catheter, which encourages clotting inside the bulge and reduces the risk of rupture.
• Embolisation: Blocking of abnormal vessels, such as those in an AVM or some tumours, with special materials delivered through a catheter, either as a treatment or to prepare for surgery.
• Stroke Clot Retrieval: In selected patients with a large vessel blockage, removal of the clot through a catheter within a limited time window, based on imaging and clinical findings.