Carotid Artery and Intracranial Stent Placement

Blood vessels inside the brain are prone to narrowing or hardening. Called "intracranial atherosclerosis," about 70,000 people in the U.S. each year have an ischemic stroke caused by narrowed arteries. In most cases intracranial atherosclerosis is discovered during diagnosis when a patient has a stroke, or a mini-stroke or TIA (transient ischemic attack). The risk of having a second stroke increases almost 10 times after the first stroke. Recommended treatments for intracranial atherosclerosis usually include exercise, healthy diet and weight loss together with anti-platelet and cholesterol-lowering medications. In certain cases, the narrowing can be treated with the help of angioplasty and stent placement.

Severe narrowing in the blood
vessel, as pointed by the large
arrow, and no blood filling in the
blood vessel in the back of the
brain as pointed by white
arrows.

The arrows point towards the
stent which has been deployed in
order to open the blood vessel.
 
 
 

Large arrow points towards the
blood vessel where the stent is
placed and the small arrows
shows the blood vessel which is
now filling. 

Intracranial angioplasty and stent placement is performed under general anesthesia, with close monitoring of the heart rate and blood pressure. The small plastic tube is passed through the artery in the leg (femoral artery). Through the catheter, first an angioplasty balloon is passed and the lesion is opened up so that the stent can be easily tracked and positioned across the narrowing. The stent pushes the plaque against the walls of the blood vessel, providing unrestricted blood flow to the brain. After the procedure the patient is monitored in the ICU, and then followed closely after discharge.