Neurological Intervention & Imaging Service WA

The first endovascular procedure for treatment of brain AVM was performed in the Royal Perth Hospital Radiology Department in 1979. The interventional service was one of two to receive Federal funding as a Specialist Interventional Unit in Australia to formally evaluate the efficacy of endovascular treatment of neurovascular diseases. Endovascular treatment of intracranial aneurysms has been provided by the interventional neuroradiology service since 1992.

The Neurological Intervention & Imaging Service WA (NIIS WA) commenced on July 1 2007 as the first specialist Neuroradiology Department in Australasia. NIISwa provides a statewide service for both tertiary and quaternary diagnostic and therapeutic neuroradiology. It is headquartered at Sir Charles Gairdner Hospital but services are provided at both SCGH and RPH campuses with a staff of six full time Neuroradiologists.

More than 75% of intracranial aneurysms are treated endovascularly today. The service provides a transcranial Doppler service for vasospasm in SAH and has performed balloon angioplasty for the treatment of intracranial spasm since 1995.

As of March 2008 the treatment of acute subarachnoid haemorrhage is based at SCGH. A state of the art biplane flat panel angiographic machine was opened at SCGH in 2008 with on table CT capabilities with a second unit commissioned for 2009. A dedicated Trans Cranial Doppler service is also available.

Carotid stenting has been pioneered and provided as a service to all public hospital and private patients since 1996 with a cooperative and holistic assessment and treatment of patients in cooperation with neurology and the stroke service.

A variety of other spinal and intracranial vascular pathologies are treated as well as treatment of traumatic vascular injuries, epistaxis and tumour embolisation.

The service also provides a statewide collaborative assessment and treatment of peripheral vascular anomalies and treatment of pulmonary AVMs.

The full range of interventional neuroradiological head, neck and carotid procedures continue to be offered at RPH with its biplane unit. Additionally, NIIS (WA) will be responsible for the reporting of tertiary neurological and ENT imaging across both campuses.

Advanced diagnostic imaging includes MR Spectroscopy, MR Perfusion, DTI, MR Functional, CT Perfusion and CT Angiography, performed on SCGH and RPH (2) 1.5T MR Scanners and (4) 64 slice CT Scanners. SCGH will commission a second magnet (3T) towards the end of 2008. Carotid Doppler services are provided at RPH and will be offered at SCGH in the future.

The department has forged very strong links with other departments and holds many regular interdisciplinary meetings, some involving videoconferencing across both campuses. A fortnightly intra-department CME meeting is held. Regular rotation of radiology registrars enrolled in the state training scheme is held and there are three radiology fellowships for advanced neuroradiology training.

Patients with neurovascular problems are assessed at NIIS (WA) outpatient clinics based at SCGH. Written referrals should be directed to:

NIIS (WA), Sir Charles Gairdner Hospital, Hospital Ave, First Floor G Block, NEDLANDS WA 6009. Phone: 9346 4455 Fax: 9346 3710.

NIIS (WA), Royal Perth Hospital, c/o Dept of Imaging, Wellington St, PERTH WA 6000. Phone: 9224 1069 Fax: 9224 3765

Consultants are available for personal consultation at both RPH and SCGH.