Carotid And Vertebrobasilar Atherosclerotic Disease
The brain is supplied by a total of four arteries: two carotid arteries at the front and two vertebral arteries at the back of the neck. Atherosclerotic disease occurs when plaque develops in blood vessels, progressively decreasing blood flow to the distal organ. In the brain, stroke can occur when plaques develop in the arteries and either progressively narrow the vessel to critical point or, break off and block smaller vessels. Patients can then either get what’s called transient ischemic attach (TIA) where symptoms are temporary and resolve with in 24 hours or a debilitating stroke, which is permanent.
Treatment options include medications to lower blood pressure, cholesterol, blood thinners such as aspirin and cessation of smoking. Non medical management includes opening of the vessel and removing the plaque through an endarterectomy procedure or placing a stent via endovascular approach for those that are not good open surgical candidates.
At WNS our goal is to have a team approach between neurologists and surgical team to provide treatment to achieve the best outcome. Although we provide comprehensive management for stroke victims via both clot busting drugs and endovascular retrieval of clots, our philosophy is focused on preventing stroke from happening. TIAs are the best warning signs for an impending stroke: about 1/3 of TIA patients can subsequently have a stroke. At WNS, we have launched a TIA clinic to ensure patients are seen within 24-48 hours after symptom onset. Referring physicians or patients can call directly to our clinic where they will be initially assessed by a neurologist and have diagnostic studies done within the same visit. Evidenced based treatment is initiated by combined effort between surgeons and neurologists. This helps avoid long waits in the ER and potentially unnecessary hospitalizations