Scientific Research Institutes > University Institutes > Neurointervention

Institute for Neurointervention

Head: a.o. Univ.-Prof. Dr. Monika Killer-Oberpfalzer



The neurointervention (also: interventional neuroradiology, neurosurgical angiography, surgical neurology) is a specialist field of the medicine which is specialised in endovascular treatment of vascular disorders of the brain, spinal cord, head and neck as well as other peripheral vascular malformations.

The possibilities of the interventional therapy comprise, for example, the treatment of aneurysms (coiling-, balloon- or stent-supported methods), Carotis stenting, topical lysis, clot retrieval, intracranial stents, pre-operative embolisation of tumours, treatment of AVMs (arterio-venous malformations) and AVFs (arterio-venous fistulas) and angiographies in intervention readiness.

In recent years, a strong orientation to the minimum invasive techniques was observed in the angiopathy area. The interventional methods are subjected constantly to further development in order to respond better to the needs of the patients.

Numerous scientific studies cover the treatment success of the various therapeutic possibilities and form an important bridge between the research and the economy in order to provide the best possible therapy for the patients.

About us

Chronicle

2000: Founding of the research department "Experimental Angiography" at the Salzburg University jointly with the "Organismic Biology" department.

2005: The "Neuroscience Institute Salzburg" was founded as interdisciplinary research and education section of the Christian Doppler Hospital by the privy councillor Univ.-Prof. Dr. Gunther Ladurner. The research section "Experimental Angiography", which until then was in the Salzburg University, was incorporated in it.

2011: Founding of the "Research Institute for Neurointervention at Paracelsus Medical Private University". In this way, the university framework conditions for experimental and clinical research were created on a wider basis and at top international level.

Goals

  • Using the available resources and contacts as well as the integration of excellent international researchers and the transfer of the basic research results to the clinic

  • Research and development in the area of neurointervention at top international level and their academic presentation

  • Continuing and expanding the neurointerventional education possibilities at international level up to a master's degree study in neurointervention

An important task of the Research Institute for Neurointervention is the education and further education of physicians, students and radiology technologists. On the basis of the clinical experience here but also through the Austrian and international cooperation, education at the highest level can be offered.

Teaching

The teaching events at the Research Institute for Neurointervention take place within the framework of the lectures in neurology at Paracelsus Medical Private University.


Telelearning

By the use of telelearning as a form of education, teaching events with top international medical specialists from the teaching and research fields can be offered to the students. While the lecturer teaches live on camera, the students can follow the lecture at any place from their computers. This form of teaching makes possible, on the one hand, the direct contact between the student and the teacher and, on the other hand, the contact between the students themselves.


Practice

Along with the theoretical part of the education, it is also possible at the research institute to apply in the practice the learned material. In cooperation with leading companies of the neurointerventional medical products industry, workshops and seminars are offered regularly at the research institute.

  • Aneurysms (treatment of pathological spasms of blood vessels)
  • Intracraneal stent (treatment of the narrowing of the brain-supplying arteries such as arteria cerebri media, arteria basilaris, arteria carotis interna)
  • Extracraneal stent
  • Carotis stent (treatment of the narrowing of the carotid artery)
  • Thrombectomy (operative removal of a blood clot from a blood vessel)


Equipment

For the offered training in neurointerventional procedures and the scientific research work there are two computer simulators available at the Research Institute for Neurointervention: The Procedicus-VISTTM system (Mentice AB, Gothenburg, Sweden) and the AngioMentorTM system (Simbionix Ltd, Lod, Israel) – both multidisciplinary simulators which permit the training in endovascular interventions with different pathologies in a secure, reproducible and completely simulated environment.

Above all, the navigation of the instruments and better understanding of the vascular anatomy are trained on the simulators in the workshops for interventional stroke therapy and aneurysm treatment under the guidance of specialists. In this way, it is possible for the so trained neurointerventionists to perform verifiably an intervention up to 30 per cent quicker. The error ratio can also be significantly reduced by training on the simulator.

Research

The main focuses in the area of the experimental neurointervention can be divided into, on the one hand, neurovascular research in the clinical area and, on the other hand, basic research.

There are many existing cooperations with regional, national and international partners from the university area and the economy. In the individual research groups, the physicians and the natural science specialists work together in interdisciplinary manner.


Main research priorities

  • The testing, further development and optimisation of the new materials and different methods, in particular for the treatment of intracraneal aneurysms, are in the focus of the scientific research work, in order to offer procedures, such as the closure of an aneurism, with as low a risk as possible and to reduce the number of the control examination of the patients. This is achieved by the use of special coated spirals which are applied for the closing of aneurysms.

  • In cooperation with the Stroke Unit of the Salzburg University Hospital for Neurology and its University Institute for Radiology, quantitative MR examinations of brain bleeding are performed by means of CT and MRI before and after the interventions. These results and examinations of the cerebral infarction in its time-based process by using multimodal MR methods (diffusion, tensor imaging, spectroscopy) provide information about the epidemiology of the stroke and serve for the research based on the newest possibilities of the prophylaxis and therapy.

  • Another research focus is the development of new methods for quick flow restoration in the closed brain vessels (e.g. by means of thromb-aspiration or thrombectomy), whereby new catheters and instruments are developed in cooperation with the industry. In this area, the Research Institute for Neuro-intervention participates in many studies and works actively together with other centres at home and abroad.

  • Furthermore, research is performed on neuroimplants for aneurysms and micro-catheters which permit the MR navigation in the brain.

  • It is worked on the development of stents which can be implanted without the dual therapy with plavix and aspirin, which was necessary until now. Also stent-type implants (flow diverters), which serve for closing of aneurysms, are now tested and further developed with respect to their long-term effect, risks and material compatibility.

  • The vascular neuroimmunology occupies itself with the neuroimmunological changes taking place in cerebrovascular diseases as well with the vascular changes with focus on the blood-brain barriers in neurological and in particular in neuroimmunological diseases. Thereby, in particular, the changes in the immunological parameters in the blood of the patients in the cases of stroke with and without neurointervention are studied and are correlated to clinical and neuroradiological parameters. Furthermore, in the area of experimental neurointervention, the influence of the various devices on the immune system is studied.

  • The focus of the research in the MR methods area is on the optimisation of special sequences for presenting the moved contents in the sense of MR-navigated neurointervention. In this area there is a close cooperation with the neurocognition research group in the psychology subject area of the University Salzburg.

Partners

Beth Israel Hyman-Newman Institute for Neurology and Neurosurgery, New York Center for Endovascular SurgeryProf. Alejandro Berenstein, MD

Mayo Clinic, Rochester, USA
Department of Neurosurgery and Radiology
Prof. David Kallmes, MD

St. Michael’s Hospital, Canada
Diagnostic and Therapeutic Neuroradiology
Tom R. Marotta, MD, FRCPC, Assistant Professor, University of Toronto

New York University, USA
Department of Neurosurgery
Prof. Howard Riina, MD

Tufts Medical Center, Boston, USA
Department of Neurosurgery
Adel M. Malek, M.D., Ph.D.

University of Oxford, UK
Oxford University Hospitals NHS Trust
NIHR Oxford Biomedical Research Centre, Acute Vascular Imaging Centre
Prof. Iris Grunwald, MD

University of Oxford, UK
Oxford University Hospitals NHS Trust
Department of Neuroradiology
Anne Schmitt, MD

Medical University Innsbruck, Austria
University Clinic for Radiology
Dr. Martin Freund

Team and contact