Stenting procedure for cerebral infarction

The stenting procedure for cerebral infarction is quite a specialized issue. Taking carotid artery stenosis stenting surgery as an example, before doing stenting treatment, adequate preoperative preparations are made to check the patient’s blood and perform relevant imaging examinations to exclude risks and ensure surgical safety. The surgical treatment is performed in the catheterization laboratory under local anesthesia, that is, after subcutaneous injection of local anesthetic into the femoral artery, a percutaneous puncture is made and the treatment is performed inside the catheter. Before treatment, the lesion is identified and understood. Usually, after the side of the lesion is identified, the stenosis is appropriately dilated through a balloon, and after entering the blood flow channel, a protective umbrella is delivered from the channel to prevent new infarcts caused by dislodged thrombotic material from being forwarded intracranially during the subsequent operation. Once the umbrella is inserted, the dislodged thrombus is retrieved and captured by the umbrella during intracranial transit, reducing the risk of new infarcts. After measuring the lesion and determining the extent of the lesion and selecting the appropriate length and width of stent, the stent is inserted through the coaxial system of the umbrella, released, and angioplasty is performed. After the angioplasty, if the stent is then seen to have a clogged wall or if the stent does not fit the wall satisfactorily, post-dilation is also required. Post-dilation is to feed the balloon through the coaxial system and further expand the stent through the balloon to make it adhere to the wall of the internal carotid artery to reduce the entrapment and avoid new thrombosis causing new intracranial infarction after the operation. In conclusion, the whole stent implantation procedure has strict operation specification and operation protocol, and as long as the treatment is performed according to the operation specification and operation protocol, relatively few special sequelae will occur. The only thing that needs to be noted is that the patient may experience sinus reflexes when the carotid stent is pre-dilated or post-dilated. Sinus reflex is a sudden decrease in the patient’s heart rate, sometimes as low as 40s or even 30s. Because the procedure is local anesthesia, the patient is usually instructed to cough or to use atropine for heart rate protection during the procedure.