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Restoration of brain-supplying vessels after narrowing (stenosis)

Narrowing (stenosis) of the carotid or cerebral arteries is most often caused by artherosclerotic wall deposits. The narrowing can reduce or even completely block blood flow to the brain. The resulting circulatory disturbance may go unnoticed for a long time, but can lead to recurrent, temporary brain dysfunction later in life. In the worst cases, the consequence is permanent disability or even a life-threatening stroke. In addition, the diseased sections of the arteries can also give rise to blockages (embolisms) and can cause occlusions of smaller downstream vessels.

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.

Why choose the USZ?

Many years of expertise

Our clinic is an internationally renowned institution in the field of diagnostics and minimally invasive, image-guided treatment. We treat diseases of the brain, spinal cord, peripheral nervous system, associated organs (eyes, auditory, vestibular, etc.), and surrounding structures of the head, neck and spine.

Latest treatment methods

At the Department of Neuroradiology, we strive to offer the best possible treatment to every patient. We therefore use the most modern interventional methods, the most advanced materials and instruments, and cutting-edge imaging techniques.

Partner network

Additionally, we hold weekly interdisciplinary conferences with experts from neurosurgery, neurology and neuroradiology during which we develop an individual therapy concept for each case. To guarantee optimal treatment selection and patient care our experienced neuroradiological interventionists further collaborate with experts from other clinics as well as with outstanding nursing and rehabilitation specialists before, during and after the intervention.

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.

Left: blocked carotid artery, right: blood flow is restored after stent treatment.
X-ray: the stent has been placed in a vessel of the neck.
The middle cerebral artery before and after treatment with a stent. Before treatment the blood vessel is constricted, afterwards the normal width is restored.

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.

Hospital stay 3 – 4 days

For patients

As a patient, you cannot register directly for a consultation. Please get referred by your primary care physician or specialist. If you have any questions, please contact our patient secretariat.

Tel. +41 44 255 56 01

For referring physicians

Register your patient for our neurovascular consultation hour through the online form or through an e-mail to the patient secretariat.

Tel. +41 44 255 56 01