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Atherosclerosis is hardening of the arteries that can result in narrowing (stenosis) or blockage (occlusion) of an artery. This can occur in any artery in the body. Risk factors for the development of atherosclerosis include: high blood pressure, high cholesterol, diabetes, smoking, obesity, and genetic disposition.
When an interventional neuroradiologist is involved in treating this problem it involves the larger arteries going to the brain (carotid or vertebral arteries) or the arteries inside the head (intracranial arteries).
Atherosclerosis of the carotid arteries often causes transient ischemic attacks (TIAs) because the blood flow may be lowered to the point that a portion of the brain is temporarily not functioning normally. Typical symptoms may include weakness or numbness on one side of the body, inability to speak or understand speech, and changes in vision. If the blood flow is only decreased for a short time a TIA occurs, but if the interruption is sufficiently long a stroke occurs.
Treatment with medicine may be recommended if the narrowing is not severe. If the narrowing is more severe, surgery or endovascular therapy may be recommended. Surgery involves opening the artery and removing the atherosclerotic plaque that is narrowing it.
Endovascular therapy involves using a balloon or stent to push open the wall of the artery from within. In the carotid artery, a stent is usually placed to open the narrowing. First, the doctor places an umbrella-like device beyond the narrowed segment to catch any debris that floats off when the stent is put in. Once the stent has been postioned the umbrella is closed and removed from the artery.
Carotid stent pre-treatment
Angiogram from a patient with a severe narrowing of the carotid artery (pointed out by blue arrow). The patient had symptoms that indicated he was not getting enough blood flow to the brain, known as a transient ischemic attack.
Carotid stent post-treatment
Angiogram performed on this same patient after a carotid stent had been placed to open up the severe narrowing in the artery.
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