Cerebral pipeline stent “narrowed”?

Hi all. Curious if anyone has experienced something similar from a stent placement.

My ruptured cerebral aneurysm was coiled November 2022 and I had a carotid artery stent placed at the neck in January of this year. Today I had my 6 month follow up angiogram and while my aneurysm has closed off (thankfully!), my neurosurgeon informed me that my stent has “narrowed”. I’m wondering if I may have misunderstood this to mean that my artery has narrowed, as I can’t find anything online about what a narrowing stent entails.

He has requested I have another angiogram in 6 months time while remaining on blood thinners. If my artery and stent look good at that time, I am good to go. He said that it is absolutely possible my stent molds to the wall of my artery as it should if given a bit more time. If not, I will need an angioplasty to balloon the artery.

Has anyone else experienced anything similar to this? He has ensured me there’s nothing to worry about and with continuing my blood thinners, I’m not at any heightened risk of stroke, though as we all know it’s always something to look out for. I’m following up with him Monday to make an appointment for more info! This is simply a curiosity post, as each of our journeys can be so vastly similar yet have some overlapping niche qualities. I’m not sure if I recall hearing or reading about this specific situation elsewhere.

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I had to do a bit of searching, it’s called Restenosis. I couldn’t find anything at first on it for cerebral stents, but I imagine it’s the same as coronary stents This explains it Restenosis: Definition, Symptoms, In-Stent Thrombosis, and More. I do recall Dr. Q-W explaining scar tissue could form too much around the stent and she would do the normal six month follow up. I imagine now that I went on a search this is what she was talking about.

We have had members whose stent didn’t do what it should’ve and they’ve had different procedures to fix them.

If you find something related to cerebral stents, please share it. I’m very interested in this topic!

I just found these by doing a search on “pipeline Restenosis” not sure it’s the same without knowing what your surgeon is calling it though Treatment of In-Stent Stenosis Following Flow Diversion of Intracranial Aneurysms with Cilostazol and Clopidogrel - PMC. And this https://www.frontiersin.org/articles/10.3389/fneur.2023.1140497/full

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Thank you for your reply and the links @Moltroub. I will look into that. I don’t recall hearing him say the word stenosis or restenosis, which was why I was confused. Perhaps I missed it during a busy and overwhelming day in the hospital — we all know how those go!

I will add any more information I receive after meeting with him again.

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Stenosis is a narrowing of something, in our case the stents I presume. I can’t wait even though I have to for what you learn. Thank you so much for your willingness to share!

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Wanted to send a quick update!

I had my second and last angiogram (hopefully-ha!) a few weeks ago and received the all-clear. This allowed me to cease taking blood thinners aside from an aspirin which I will of course continue to take throughout life— a small price to pay indeed.

In the event anyone else experiences and subsequently searches for this later on, what occurred in my case was rare based on what my neurosurgeon said, but can and does happen.

How he explained it to me is that generally after a stent is placed, the immune system sends cells to help create a new layer around the stent, “rebuilding” the artery wall, so to speak. In my case, my immune system sent an inordinate amount of cells to aide in the rebuilding, all of which caused my artery to narrow as the artery walls were far thicker than they needed to be.

Thankfully, he explained that again while this is rare, the body does generally “wash” away the excess cells in time. Out of the handful of cases of a cerebral artery narrowing after stent placement that he had seen, all but one eventually had their body flush the excess cells to unveil a fully open artery. I was no exception, and 14 months after my stent was placed my artery looked exactly as it was supposed to.

If anyone else experiences this, be sure to request further information from your surgeon and ask to see the scans from your angiogram! That helped me tremendously in understanding the specific inner workings of what was occurring, though I am admittedly a very visual person. The internet can be quite misleading with its terms and almost always associates narrowing arteries to plaque buildup, which of course in instances like ours after a stent placement, is not the case.

:white_heart:

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Karly, you are a fantastic teacher! The ability to pass on knowledge is a great gift, thank you for giving to us. I believe you have a very bright future ahead of you, I’m sure of it.

I get my three year follow up MRI/A this year and I’m actually looking forward to it :crazy_face::joy:

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