For Patients & Their Families

Blood vessel narrowing (stenosis) : stenting of the vessels supplying the brain
(For pictures of "stenting", click here)

Ischemic stroke is the type of stroke which occurs due to loss of blood supply to a particular part of the brain. Like in a heart attack which is many times preceded by mild chest pain, there are warning signals even in patients of stroke. These are called TIAs (Transient Ischemic Attacks). Here the patient has symptoms like slurring or loss of speech, tingling or weakness in one part of the body, vertigo, imbalance while walking, visual loss etc lasting for a few seconds to hours. These episodes are invariably neglected by patients and doctors alike, ascribing them to just ‘high’ or ‘low BP ’or‘general weakness’. This neglect can push the patients towards a major stroke which can be life threatening or permanently disabling.

When a patient develops a stroke or a TIA he is investigated for risk factors like Diabetes, Hypertension, High Cholesterol, Smoking, family history etc. Also certain tests are done to ascertain whether there is a significant obstruction in the blood vessels supplying the brain. This is done to prevent recurrence of the stroke or to prevent conversion of the TIA into a full blown stroke.

Carotid Doppler & MRA (MR Angiogram) are simple tests to detect obstruction in the brain’s blood supply. However, these are many times not enough to take decisions on definitive treatment as they are not very accurate & can miss or misinterpret obstructions in particular locations. Here the patient needs to undergo a DSA (Digital Subtraction Angiogram) which is in simple words an angiography of the brain.

If the obstruction confirmed on DSA is mild (< 50%), medical treatment is advised. However, if it is significant (> 50%) just medical treatment & control of risk factors is not enough & the patient may need to undergo stenting (angioplasty) of the vessel which is obstructed. Of course the decision may vary from patient to patient depending on the patient’s age, medical condition & other factors.

The risk associated with stenting in the hands of a trained & experienced operator is much less than the risk of recurrent stroke if the obstruction is left as it is. Also stenting may be required to be done urgently especially if the obstruction is severe or the patient keeps getting recurrent TIAs inspite of adequate medical treatment.

BVN-Stenosis

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