Introduction
Brain stent surgeries such as coronary angioplasty are done to restore circulation in the brain. Stents are placed in order to relieve the clogged arteries and restore blood circulation to the brain. Brain stents are implanted devices in the brains of individuals who pose high-risk brain conditions. Stents are not solid similar to walls, but they mimic the function of a wall by preventing the arteries from being squeezed shut. Stents are varying in size and are made of wire mesh, made up of nitinol (a blend of nickel and titanium), capable of expansion.
What Are the Indications for a Brain Stent Surgery?
Brains stents are indicated mainly or treating brain aneurysms (ballooning of blood vessels) and intracranial stenosis (narrowing of blood vessels of the brain).
1. Brain Aneurysm - An aneurysm refers to a weakened section in the wall of a brain artery that protrudes or balloons out often resembling the shape of a berry or blister. This condition can occur as a result of injury, infection, and inheritance. Smoking and high blood pressure are also risk factors precipitating this condition. Following this, the bulge can stretch and cause damage to the wall due to further thinning. A rupture of this can lead to major disabilities.
2. Intracranial Stenosis - Stenosis simply refers to narrowing. Plaque building up within the artery can interrupt blood supply to the brain causing intracranial stenosis. This in turn will lead to stroke resulting due to narrowing of the artery. Some patients with intracranial stenosis experience positive outcomes with the help of certain medications like Aspirin and blood thinners, and adopting a few lifestyle modifications. However, in cases of severe intracranial stenosis, those who continue to exhibit symptoms, despite taking medications, may require stent placement surgery. A 70% of blockage or more than that denotes severe intracranial stenosis.
What Is Brain Stent Surgery?
With the help of angiography, a catheter (a medical device resembling a thin tube) is inserted and the stent is delivered along the same path as the catheter, and placed in the desired location. After placing the stent, the catheter is slowly removed. A guide wire is used along with detachable coils that pass through the catheter to release the aneurysm. This coil will fill the aneurysm and prevent it from circulating, thus allowing blood clot formation. This will obliterate the aneurysm, and post this, a stent is placed for stabilizing the artery to act as a barrier preventing the coils from protruding back into the main blood vessel. Angiography is recommended for six months after the placement of a stent. This is done to make sure the stent is in a good position holding the artery wide open. Further imaging is necessary after six months with additional investigations. Having a stent does not contraindicate undergoing X-rays, angiography studies, and CT scans.
What Is the Prognosis of Brain Stent Surgeries?
Due to the recent introduction of stent placement for brain aneurysms and intracranial stenosis, ongoing research is still investigating the prognosis of this surgery. Some studies have shown that stent placement can significantly lower the risk of stroke in patients who have symptomatic intracranial stenosis compared to those undergoing medical therapy. Patients who can benefit most from this are those with strokes, as it has 70% the capability to prevent recurring strokes. Therefore, the benefits of undergoing stent placement outweigh the potential risks associated with this procedure. In the case of brain aneurysms, the majority of patients who undergo coiling followed by stent placement experience successful blockage of the aneurysm’s blood flow. This will result in a reduced risk of rupture and prevention of further deterioration.
Treatment of intracranial stenosis with stents is commonly performed with cerebral angioplasty. During cerebral angioplasty, a catheter is carefully threaded into the affected artery. The catheter used in the case is equipped with an expendable balloon near the tip. Once positioned in the narrowed area, the balloon is inflated by the surgeon, which exerts pressure on the constricted arterial walls thereby improving blood flow.
What Are the Potential Risks After a Brain Stent Surgery?
Brain stent implantation is risky like any other surgical procedure and the following are the complications of this surgery:
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Artery puncture.
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Artery dissection due to damage to the vessel lining.
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Bleeding into the brain.
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Stent movement.
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Stroke due to artery blockage.
What Is the Recovery Time After a Brain Stent Surgery?
The time duration to fully recover from a brain stent surgery may vary among individuals based on factors like the specific condition being treated, the patient’s medical history, the patient's overall health, other comorbidities, and the complexity of the procedure. Patients remain in the hospital post-surgery for a few days. In this stage, the doctors will monitor the patient’s vital signs, manage pain, and observe for any uneventful complications.
After being discharged, patients continue to heal at home. Some individuals may experience headaches, fatigue, discomfort, and pain at the surgical site. Thorough instruction and guidance for follow-up care are elaborated by the surgeons and medical team. Complete recovery after a brain stent surgery can take from several weeks to months. Therefore, it is important for the patient to adhere to the medications, rest enough, and gradually resume normal activities.
Regular follow-up appointments, follow-up scans, and treatment plan adjustments are made in the subsequent period during healing. Patients should closely follow the post-operative instructions in order to heal faster. Each patient’s factors are unique therefore healing can differ among individuals.
What Are the Precautions to Be Followed During Recovery?
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The incision site should be kept clean.
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After cleaning, dry the incision.
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Change dressings as instructed.
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Avoid straining and moving unless otherwise instructed.
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Follow the prescriptions as advised by the doctor.
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Restrain from using alcohol and tobacco consumption.
Conclusion
Recovery time following a brain stent surgery can vary and is unique in each individual based on factors like the patient's medical history, type of surgery performed, adherence to the post-operative instructions, etc. Certain factors like not maintaining the incision site clean, physical exertion, and coexisting morbidities can delay recovery. Therefore a separate treatment plan is recommended by the surgeon for each patient undergoing the surgery. Strict adherence to the protocol and instructions by the patients is important for quick healing.
