Vertebral Artery Stent Angioplasty

Vertebral Artery Stent Angioplasty | Vascular Neurology of Southern California

Within your neck, there are two pairs of large blood vessels, called carotid and vertebral arteries that carry oxygenated blood to your brain.

Located at the back of your neck, these blood vessels come together at the base of the brain to form one artery known as the basilar artery. Jointly known as the “vertebrobasilar artery system,” these arteries supply blood to those parts of the brain responsible for controlling movement, reflexes, blood pressure, balance, as well as other functions.

The inside of a healthy vertebral artery would normally appear smooth and wide open, providing an easy route for the blood to flow to your brain. Unfortunately, due to several factors involving age and lifestyle choices, these arteries can become clogged with a sticky substance made up of cholesterol, calcium, and other materials collectively known as plaque. This condition is often referred to as the narrowing of the arteries or artery stenosis.

Over time, plaque might continue to build up on the walls of these arteries. Arteries can become so congested that blood flow becomes restricted, a condition known as vertebral artery stenosis.

Since vertebral artery stenosis can reduce or even block the blood flow to your brain, your risk for experiencing a stroke may significantly increase if you have the condition. The term “transient ischemic attack (TIA)” is used to describe when a blood clot becomes lodged in an artery of your brain, preventing blood from flowing through that artery and to the brain.

What Are the Symptoms of Vertebral Artery Stenosis - Narrowing of the Arteries?

It is possible that someone with vertebral artery stenosis does not experience symptoms until it has reached an advanced stage when the blood flow to the brain has been interrupted to the brain. Because these vertebral arteries carry blood to areas of the brain that control balance and movement, many people may experience signs that they are at risk of falling down.

When arteries narrow, symptoms often slowly develop but gradually become worse over time. These symptoms include:

  • Trouble swallowing
  • Vertigo or dizziness
  • Confusion and difficulty understanding speech
  • Difficulty speaking and exhibiting slurred speech
  • Sudden “drop attacks” with unexplained falls while still being conscious
  • Severe weakness in the legs that can also result in falls
  • Difficulty seeing through one or both eyes, or blurred or double vision

A severe case of vertebral artery stenosis might cause a stroke or TIA and result in the following additional symptoms:

  • Numbness, paralysis or weakness in an arm, leg or the face, especially on one side of the body
  • Severe headache, perhaps accompanied by vomiting
  • Loss of consciousness
  • Dizziness or loss of coordination or balance, including difficulty with walking
  • Labored breathing

BOW HUNTER SYNDROME: Occurs when there is an external compression of vertebral artery usually as a result of bony spur.  This results in above symptoms on turning your head in one direction or the other.

Keep in mind that a stroke is a medical emergency, and you should immediately call 911 if you or someone you know experiences any of these sudden symptoms.

Should you or a loved one have any concerns about vertebral artery stenosis, or if you seek the best professional advice on how to diagnose and treat the artery stenosis, reach out to Dr. Muhammad Asif Taqi. He is a triple-board certified neurointerventionalist and stroke neurologist who may be contacted online or reached at (805) 242-4884.

Are You at Risk of Having Vertebral Artery Stenosis?

Even if you are not experiencing any of the symptoms of vertebral artery stenosis, several risk factors could increase your likelihood of developing vertebral artery stenosis in the future:

  • Family history of vertebral artery stenosis
  • High cholesterol
  • High blood pressure
  • Smoking
  • Obesity
  • Sedentary lifestyle due to a lack of exercise or other physical activity
  • Diabetes

Your risk also increases with age for both men and women, especially if you are over 50.

How Is Vertebral Artery Stenosis Diagnosed?

Should your doctor suspect you may have vertebral artery stenosis, he will plan to conduct one or more of the following tests:

Ultrasound: A non-invasive test using sound waves to generate images of your vertebral arteries can confirm whether plaque has accumulated inside them.

To more precisely assess what is going on inside your arteries, ultrasound tests are often performed in combination with the additional tests outlined below:

A CT (Computerized Tomography) scan: Captures X-ray images of your brain and vertebral arteries. These are matched with the results of a special radiopaque dye injected into your bloodstream that outlines them on x-ray. Called CT angiography, this will indicate how well blood is flowing through your vertebral arteries and into your brain.

Magnetic resonance imaging (MRI) scan: Records 3-D images of your brain and blood vessels and sometimes uses a variation known as MR angiography or MRA. The vertebral arteries may be seen in greater detail with this type of scan.

Cerebral angiography: Another minimally invasive test, this combines X-rays as well as a special dye to examine inside the arteries in your brain.

How Is Vertebral Artery Stenosis Treated?

If you’ve been diagnosed with narrowing arteries in the back of the neck, Dr. Taqi will develop a specific treatment plan with you. This plan takes into account the severity of your condition, any symptoms you might be experiencing, as well as your overall health.

Apart from prescribing medication and lifestyle changes, your doctor may recommend one of the procedures outlined below. The first three are surgical procedures and significantly more invasive than the fourth:

Endarterectomy

A surgical procedure where the surgeon makes an incision in the patient’s neck, opens the affected vertebral artery, and physically removes the plaque that is blocking the vessel.

Vascular bypass surgery

Also known as bypass grafting, this is an open surgical procedure that allows the surgeon to create a diversion around the narrowed or blocked portion of the artery. This “bypass,” made from one of the patient’s own veins or synthetic material, allows blood to flow around the blockage.

Vertebral artery reconstruction

A surgical procedure where a portion of the vertebral artery is moved to an adjacent, healthy artery where the two arteries are sewn together.

Angioplasty and stenting

This is a minimally invasive procedure that does not require open surgery or general anesthesia. Using x-ray fluoroscopy or other imaging technology, the surgeon threads a small, flexible tube called a catheter through a minor incision in an artery, which is usually located in the groin area. Once it reaches the artery that has become narrowed due to cholesterol-filled plaque, the catheter is then used to inflate the artery with the aid of a tiny balloon wrapped in a collapsed wire mesh stent. This typically lasts for only a short length of time, after which the stent stays positioned to keep the artery propped open.

Dr. Taqi will take additional X-rays to monitor how much blood flow has improved, and will then carefully remove the balloon catheter, leaving the stent in place. Once the procedure is complete, they will apply pressure to stop any bleeding from the small slit in the artery. A closure device and then a dressing will be used to seal this small wound, and no stitches will be visible on the skin.

When the procedure has been completed, the patient will be transferred to a recovery room and await further instructions from Dr. Taqi and his team.

Risks Associated with Artery Stent Angioplasty

Generally, angioplasty surgery is safe, but ask your surgeon about the possible complications.

Risks of angioplasty and stent placement include but may not be limited to the following:

Allergic reaction: This could be to the drug used in the stent, the stent material itself (very rare), or the x-ray dye.

Bleeding or clotting: Affecting the area in the groin where the catheter was inserted.

Blood clot: This could be in the area of the angioplasty.

Clogging of the inside of the stent: Known as in-stent restenosis, this can be life-threatening.

How Should You Prepare for Your Artery Stent Angioplasty?

In your consultations with your surgeon, tell him about all the medications you take, including any supplements. List any allergies you might have, especially to general anesthesia, local anesthesia, or contrast materials. Before your procedure, your doctor may tell you to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or blood thinners.

In most cases, you should be able to take your usual medications, especially those for blood pressure. These should be taken with small sips of water on the morning of your procedure.

Be sure to tell Dr. Taqi and his staff about any recent illnesses or other medical conditions.

Women should always inform the doctor and x-ray technologist if there is any possibility that they might be pregnant. In order to avoid exposing the fetus to any radiation, certain imaging tests should be avoided during pregnancy. However, if an x-ray is necessary, we will take precautions to minimize exposing the baby to radiation.

Other than medications, your doctor may ask you not to eat or drink anything for several hours before your procedure.

Vertebral Artery Stenosis Care by Dr. M. Asif Taqi in Thousand Oaks, CA

Dr. Taqi’s practice continues to build upon a legacy that blends compassion, safety, and innovation. As Southern California’s leading neurointerventionalist and experienced neuroendovascular surgeon, he provides the full spectrum of evidence-based care, including the latest minimally invasive procedures offered only by neurointerventionalists with advanced training and experience.

If you or your loved one have been diagnosed with vertebral artery stenosis, contact Dr. Taqi online or call (805) 242-4884 to schedule your appointment today.