Neuroendovascular Program

Neuroendovascular therapy treats complex conditions of the brain such as stroke, aneurysm and arteriovenous malformations (AVMs). This advanced therapy is available in Portland, Maine where patients have 24/7 access to time-sensitive treatments. Our team of fellowship-trained neuroendovascular specialists provides responsive, sophisticated care that consistently saves lives and dramatically minimizes disability.

Program Highlights

Maine Medical Center’s neuroendovascular team is distinguished by numerous attributes, including:

  • 24/7 access to life-saving care for acute cerebrovascular conditions
  • A team of fellowship-trained subspecialists with neuroendovascular expertise who provide the best treatment options available
  • Cutting-edge technology and techniques for treating cerebrovascular conditions like stroke, aneurysms and arteriovenous malformations (AVMs)
  • A full range of treatment options so that medical care can be tailored to the unique needs of each individual patient
  • Emergency treatment protocols to provide efficient and time-sensitive care
  • The most advanced imaging technology
  • A coordinated & multidisciplinary approach to care in a collaborative, patient and family-centered environment
  • Neuro-certified nurses who deliver exceptional care
  • Integrated rehabilitative care in partnership with New England Rehabilitation Hospital so that patients get a coordinated recovery plan
  • A Telestroke Network that uses videoconferencing and digital imaging technology to bring Maine Medical Center’s stroke expertise to community hospital emergency departments 24/7
  • The Telestroke Network helps to identify stroke patients who can benefit from Maine Medical Center’s neuroendovascular expertise and speed up their transfer to MMC.

Conditions Treated

The neuroendovascular specialists at Maine Medical Center are experts at treating the following cerebrovascular conditions:

  • Stroke
  • Ischemic stroke
  • Hemorrhagic stroke
  • Transient ischemic attack (TIA)
  • Cerebral (brain) aneurysm
  • Arteriovenous malformation (AVM)
  • Cerebral artery stenosis
  • Carotid artery occlusion or dissection

Cerebral Thrombectomy

Cerebral Thrombectomy is a recommended option to remove a clot in eligible patients with a large vessel occlusion stroke or LVO. In this procedure, doctors use a wire-cage device called a stent retriever. They thread a catheter through an artery in the groin up to the blocked artery in the brain. The stent opens and grabs the clot. Special suction tubes may also remove the clot.

The procedure:

  • Should be done within six hours of onset of acute stroke symptoms
  • Can benefit patients under certain conditions if done within 24 hours of onset
  • Should include Alteplase IV (tPA) treatment in eligible patients 

Carotid Artery Stenting

Our vascular specialists use a procedure called angioplasty to widen the carotid arteries and restore blood flow to the brain. For this procedure, a thin tube with a deflated balloon on the end is threaded through a blood vessel in your neck to the narrowed or blocked carotid artery. The balloon is then inflated to push the plaque outward against the wall of the artery. A stent (a small mesh tube) is then put in the artery to support the inner artery wall. The stent also helps prevent the artery from becoming narrowed or blocked again.

The illustration shows the process of carotid artery stenting. Figure A shows an internal carotid artery that has plaque buildup and reduced blood flow. The inset image shows a cross-section of the narrowed carotid artery. Figure B shows a stent being placed in the carotid artery to support the inner artery wall and keep the artery open. Figure C shows normal blood flow restored in the stent-widened artery. The inset image shows a cross-section of the stent-widened artery. Source: https://www.nhlbi.nih.gov/health-topics/carotid-artery-disease

Tcar (TransCarotid Artery Revascularization)

The Tcar procedure allows balloon angioplasty and stenting to be completed while blood flow is being reversed away from the brain. Doing it this way prevents small pieces of plaque that may come loose during the procedure from entering the brain.

For this procedure, a small cut is made just above the collar bone. A flexible tube is placed into the artery and connected to a medical device to reverse blood flow. The blood is filtered and returned to the brain through a second tube that is put into the femoral vein, near the thigh. After the second stent is placed, blood flow reversal is turned off. Blood flow to the brain starts flowing in its normal direction again.

Carotid Endarterectomy

Carotid endarterectomy is a surgery that removes plaque (fatty deposits) from the carotid arteries in your neck. Carotid arteries supply blood and oxygen to the front part of our brain. If plaque and other fatty materials block an artery, it slows or blocks the blood flow, and this could lead to a stroke.

Carotid Stenting

Source: https://www.nhlbi.nih.gov/health-topics/carotid-artery-disease

A: The blocked section of the carotid artery is identified.
B: The artery is opened and the plaque is removed.
C: The cleaned artery is closed and secured.

 

Quality Outcomes

Our Commitment – Maine Medical Center

Maine Medical Center is dedicated to improving the health of the communities we serve. We value patient-centered care, integrity, ownership, excellence, respect and innovation.

74% of MMC stroke patients are able to return home or go to rehabilitation after their hospital visit.

 

Maine Medical Center is included in the Vascular Quality Initiative, a nationwide prospective database used to collect and analyze outcomes of surgical and minimally invasive vascular procedures. Participation in the initiative allows us to collaborate with other institutions to enhance cerebrovascular treatment outcomes and maintain quality reporting.

Carotid Artery Stenting and Carotid Endarterectomy Procedures 2013 – 2017 Volumes

2013 - 2017 Volume Stroke (%) Hospital Mortality (%)
Carotid Stenting 158 0.70% 1.94%
Carotid Endarterectomy 754 0.67% 2.72%

Brandon's Story

When Brandon suffered a stroke following a major automobile accident in Presque Isle, he was transported to MMC. The neurosurgical team performed a mechanical thrombectomy to remove a clot and saved Brandon’s life, enabling him to make a remarkable recovery.