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Cerebral Revascularization

Cerebral vascular insufficiency, typically caused by extra or intra cranial steno occlusive pathology, is a major determining factor in the causation of stroke. Many techniques have been developed to correct the pathologic flow reduction in the cerebral circulation. The blood circulation to the ischemic brain can be augmented in many ways.

The developments in the imaging and the operative equipment has paved the way for many surgical procedures like

  • Carotid endarterectomy: where the plaque in the main blood vessels to the brain are removed surgically
  • Embolectomy: here the migrated thrombus in the blood vessel can be removed surgically from accessible locations.
  • By pass procedures: where the blood supply is augmented by using another vessel to bypass the steno occlusive pathology in the brain.

Of late many endovascular procedures are in vogue. These are minimally invasive with patients making faster recovery. They include

  • Angioplasty: where a balloon is placed across the stenosis segment and dilatation of the balloon restores the normal circulation.
  • Stenting: this augments the dilatation procedure and acts as a scaffold to prevent restenosis. But patients have to be on blood thinners.
  • Embolectomy: where a migrated thrombus can be removed either by vigorous suction or by using a stent (stentreveirs)

The entire gamut of cerebral revascularization procedures plays a crucial role in the treatment of stroke.

Authored By Dr. Sai Sudarsan

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