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Dotter Interventional Institute

Neurointerventional Clinical Research

The neurointerventional group has concentrated on treatment of carotid artery obstructions, management of acute stroke, and arteriovenous fistulas and malformations.

In the treatment of carotid artery stenoses, the Institute’s neurointerventional group found percutaneous transluminal angioplasty very effective, but recently preferred stenting of stenoses, to decrease the rate of restenoses.

Successful stenting of proximal internal carotid artery stenosis. A) Before, B) after stenting.

The stent placement has been used effectively not only for treatment of stenoses of the internal carotid artery, but occasionally for intracranial stenoses. More than 100 patients with obstructive carotid and intracranial disease were treated with stent placement. The neurointerventional team is participating in a multi-institutional Carotid Revascularization Endoarterectomy vs. Stent Trial (CREST).

Acute stroke treatment with catheter-directed, local intra-arterial thrombolysis, is being done in cooperation with the Oregon Stroke Treatment Center at OHSU and is a part of a multi-institutional study with the Institute as one of the research sites. After CT scan exclusion of intracranial bleeding, and new brain infarct and angiographic documentation of the intracranial arterial occlusion site, a microcatheter was guided inside a clot and a thrombolytic agent was infused. Restoration of perfusion of the occluded vessel and excellent clinical results were achieved in more than 300 treated patients.