Restoration of brain-supplying vessels after narrowing (stenosis)

Treatment options depend on the extent of the narrowing, on clinical symptoms, and on other diseases being present. For most cases, the treatment method is determined in a multidisciplinary meeting of specialists in neurosurgery, neurology and neuroradiology.

Our clinic specializes in the minimally invasive treatment of stenoses. We aim to improve the blood flow to the brain and to prevent strokes by reconstructing the carotid and cerebral arteries through the carotid artery (endovascular). Minimally invasive means that we will not directly open the blood vessel, but we will only puncture the leg artery in the groin or an artery of the upper arm or wrist. Through this opening, we then probe the diseased vessel with special catheters and materials. We first dilate the constriction with a balloon catheter (angioplasty) and then support it with a mechanical scaffold made of metal alloy (stent).

Advantages and disadvantages

 Advantages

• No need for open surgery which bears a higher risk for complications
• Faster wound healing
• Shorter hospital stay
• A particular advantage is that this procedure can also be performed on patients who cannot undergo surgery (e.g. due to poor cardiac performance, high risk during anesthesia, after radiation to the soft tissues of the neck, etc.).

Disadvantages

• In rare cases, dilatation and reconstruction is not sufficient for severely calcified or very tortuous vessels.
• Patients need to be treated with blood thinners for a period of time.

Course of treatment

Treatment starts with the diagnosis and the decision to use minimally invasive methods. After discussing this with you during a consultation, we will schedule a timely appointment, which is in keeping with the urgency of your case and your special wishes.

The treatment requires a hospital stay of three to four days. You will arrive the morning before the procedure and we will assess your current status and make the final preparations. We will use this opportunity to answer any questions you might have. On the day of the procedure, you will be taken from the ward to one of our two operating rooms, where the surgical team will meet you and perform the procedure.

Aftercare

Immediately after the procedure, we will examine you to make sure everything went well. We will then transfer you to a specialized monitoring ward where you will be cared for until the next day. On the following day, you will undergo a magnetic resonance examination to assess the surgical outcome and rule out any complications. Normally, you will then return to the standard ward and after another one or two days you will consult with a specialist and can then go home. During this last consultation, we will schedule appointments for further check-ups.