Stroke care has come a long way. Doctors have learned a lot from treating heart disease with angioplasty and stenting. They have transferred that knowledge to treating strokes, as catheter-based interventional procedures are among the treatment options for stroke patients. But before determining the appropriate treatment option for a stroke patient, doctors must quickly determine if the stroke is ischemic or hemorrhagic.
Ischemic stroke and carotid artery stenting
An ischemic stroke happens when blood flow to the brain is restricted or blocked. Depending on the severity of the blockage, doctors may choose to perform carotid artery stenting, which involves inserting a small plastic tube (catheter) through an artery in the leg and threading it through the blood vessels to the blockage in the neck arteries. A thin wire (guidewire) with a collapsible umbrella-like filter device attached to its end is advanced via the catheter to a point just beyond the blockage.
When opened, the “umbrella” filters the blood flowing to the brain, preventing bits of plaque or blood clots from passing to the brain and causing a stroke. The blocked artery is widened by inflating a tiny balloon inside the vessel. This pushes the plaque against the artery’s walls and makes way for the stent, a small metal tube inserted to prop open the artery. Once the stent is in place, the umbrella filter and catheter are removed.
Hemorrhagic stroke and aneurysm embolization
A hemorrhagic stroke occurs when a blood vessel in the brain bursts or weakens, allowing blood to leak into the brain. With this type of stroke, it’s imperative to control the bleeding. Like an ischemic stroke, a hemorrhagic stroke can be treated with interventional procedures. Depending on the stroke’s cause, your doctor may place coils to occlude the aneurysm. A catheter delivers a tiny coil to fill an aneurysm in this procedure. This seals the aneurysm from connecting arteries, reducing the risk of rupture.