Medical Management
We have experts in vascular neurology that will evaluate each patient for any and all risk factors associated with disease progression and – when appropriate – develop a personalized regimen of medication with close appointment follow-up. This includes anti-platelet medication, anti-coagulation (blood thinners), cholesterol and hypertension-modifying medications, along with lifestyle modification.
Endovascular Options
Most patients will undergo a diagnostic angiogram using wires and catheters, through either the wrist or groin artery, to evaluate the blood vessels of the brain, head, and neck. This procedure is performed generally as an outpatient appointment and takes about an hour, with 1-4 hours of recovery before discharge. Since this procedure involves entering the arteries of the head and neck, it is classified as invasive and therefore has a small risk of causing a stroke. We take every precaution possible to prevent this and the risk of stroke is less than 1%. This procedure is generally required for a thorough evaluation of the blood vessels.
In some cases of SOD or carotid or vertebral stenosis, endovascular stenting may be an option to enhance blood flow to the brain. Any stenting requires that the patient take 2 separate antiplatelet medications (usually aspirin and Plavix) for 6 months, and a single antiplatelet agent thereafter.