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Treatment / Protected: Intracranial Stenting

Intracranial atherosclerosis is the build up of a substance called plaque in the arteries that supply the brain with blood, causing the narrowing and blockage of these vessels. If a vessel becomes completely blocked or severely narrowed, blood flow to the brain can be compromised and a stroke can occur.

Am I a Candidate for Intracranial Stenting?

Some patients who have intracranial stenosis have good results with medications like aspirin or other blood thinners and by making lifestyle changes. Stent placement is recommended only for those experiencing symptoms from their severe intracranial stenosis that has been refractory to optimal medical treatment. Severe intracranial stenosis is defined as 70% blockage or more.

What to Expect from the Procedure

When used to treat atherosclerosis in either the carotid arteries or intracranial arteries, stents act as a permanent implant that opens these blocked arteries, allowing blood to flow to the brain.

Under image guidance, a catheter is inserted (usually in the leg) and then threaded through an arterial super highway eventually reaching the brain. The stent delivery system follows the same path as the catheter, and thus, carries the stent to the treatment site. As the stent is positioned, it expands to conform to the inside contours of the artery wall. After placement, the catheter is removed and the stent stays in place.

Compared with the carotid arteries, the arteries inside the brain are very small and make a lot of twists and turns, so they’re somewhat difficult to navigate with a catheter. Because of this intracranial stent placement requires expertise and specialized equipment.

Risks

There are a variety of complications that can occur including, artery perforation, damage to the lining of the vessel, bleeding into the brain, and stroke from artery blockage. Patients are encouraged to discuss options, risks, and benefits with their physician to make an informed decision about the best course of treatment for their individual situation.

Medications

Your doctor may prescribe antiplatelet or anticoagulant medications after your procedure. These drugs lower the risk of clot formation. Your doctor may also prescribe medications to lower your blood pressure of cholesterol. He or she may also recommend ways to control your risk factors, such as quitting smoking, exercising and losing weight.

How Effective is Intracranial Stenting?

The use of stents for brain aneurysms and intracranial stenosis are relatively new procedures, the long-term results of stent placement are still being investigated. Data from some early research studies suggest that stent placement has the potential to reduce the risk of stroke in patients with symptomatic intracranial stenosis as compared with medical therapy alone.

The patients most likely to benefit from stent placement are those with significant stenosis and have failed optimal medical therapy. For these patients the benefits of stent placement outweigh the potential risks of the procedure.

If you have been diagnosed with intracranial atherosclerosis and are exploring your options for treatment, call IVC today at 503-612-0498 to schedule an appointment for consultation.

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