In order to lower the risk of thromboembolism, patients are given antiplatelet treatment prior to the surgery, typically aspirin and clopidogrel. Clinical considerations determine whether to deliver conscious sedation or general anesthesia.
The femoral artery is typically used to obtain a percutaneous arterial access. The intracranial vascular with stenosis or disease is reached by passing a guiding catheter through the arterial system.
Contrast angiography is used to evaluate vessel diameter, properly visualize the stenotic lesion, and plan the operation.
During the surgery, intravenous heparin is used as a systemic anticoagulant to avoid clot formation.
The distal vascular branch is reached by carefully advancing a soft, atraumatic microwire through the stenotic segment. The lesion site is then reached by advancing a balloon angioplasty catheter or stent delivery device across the wire.
The narrowed vessel segment is dilated by carefully inflating a balloon across the stenosis. In order to prevent vascular rupture, inflation pressure is monitored.
In order to scaffold the vascular wall, restore lumen diameter, and stop recoil, a self-expanding or balloon-mounted stent is placed over the lesion.
To guarantee ideal stent expansion and vascular patency, further balloon angioplasty may be performed.
Stent placement, vascular patency, and the lack of problems like dissection or thrombosis are all confirmed by repeat angiography.
Access site hemostasis is achieved by removing catheters and wires, frequently using manual compression or closure devices.
For 24 to 48 hours, patients in an intensive care unit are observed for neurological abnormalities and consequences.
To avoid in-stent thrombosis, dual antiplatelet medication is maintained for several months. Vessel patency and restenosis are evaluated by follow-up imaging.
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Despite receiving the best possible medical care, patients with symptomatic cerebral atherosclerotic stenosis (usually 70–99% narrowing) experience recurrent or progressive symptoms, such as stroke or transient ischemic episodes (TIAs).
People whose anatomy, comorbidities, or significant surgical risk make them unsuitable for conventional surgical procedures.
Individuals who require the restoration of cerebral artery patency due to prolonged complete blockage or arterial compression (due to atherosclerosis or external mass effect).
Instances of severe intracranial artery stenosis affecting the internal carotid, vertebral, or basilar arteries, as well as situations in which vigorous medical treatment has not been successful or in which medication or lifestyle modifications are unable to control the condition.
In certain acute stroke scenarios, intracranial stenting can be used as a rescue method following an unsuccessful mechanical thrombectomy.
Stenting can help people with venous sinus stenosis who have high-pressure headaches or vision issues.
By opening cerebral arteries that are constricted or occluded, this technique greatly improves blood flow to brain regions, lowering the risk of stroke and transient ischemic episodes (TIAs).
It avoids big surgical incisions by utilizing tiny catheters into the blood vessels, which results in less trauma, less suffering, and shorter hospital stays.
(restenosis) and improve long-term results, durable vessel support stents offer a sturdy scaffold to maintain arteries open over time.
For patients who still experience symptoms despite receiving the best possible medical care, this intervention provides a useful substitute.
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