How are cerebrovascular interventions performed?

  Interventional therapeutics is an emerging discipline in the field of modern medicine. It is the use of minimally invasive operating techniques with the help of imaging equipment to perform vascular and non-vascular endoluminal treatments to solve some problems that are difficult to be solved by internal medicine or surgery alone.  About 70% of cerebrovascular diseases are ischemic cerebrovascular diseases, and ischemic cerebrovascular diseases are mainly caused by narrowing or occlusion of cerebral blood vessels. Interventional endovascular treatment brings hope to patients with certain ischemic cerebrovascular diseases that lacked effective treatment in the past.  Before endovascular intervention for ischemic cerebrovascular disease, cerebral angiography or cerebrovascular imaging must be performed, the purpose of which is to understand the vascular status of the aortic arch, internal carotid artery system and vertebrobasilar artery system, to determine whether there is cerebrovascular lesion and whether endovascular intervention is suitable. At present, the image effect of cerebral angiography is better than MRI or CT angiography in China, therefore, cerebral angiography should still be chosen for those who have the conditions.  Interventional treatment is suitable for carotid stenosis: if the carotid stenosis is >70% and there are associated neurological symptoms. Or there are imaging changes of brain parenchymal ischemia associated with stenosis. Or for a small number of carotid artery stenosis <70%, but with obvious related symptoms, endovascular intervention can also be considered in hospitals that have the conditions.  For stenosis of the extracranial segment of the vertebral artery: if symptoms of ischemia in the vertebrobasilar system or recurrent posterior circulation strokes, internal anticoagulation or antiplatelet therapy is ineffective. or stenosis of >70% of the opening of one vertebral artery and dysplasia or complete occlusion of the other side. or narrowing of the opening of the vertebral artery >50% bilaterally.