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What is Carotid Angioplasty?
Carotid angioplasty and stenting are procedures used to treat carotid artery disease, which can lead to strokes. The process involves inserting a catheter into a blocked carotid artery, inflating a balloon to widen the artery, and placing a stent to keep it open.
An embolic protection device may be used to catch any debris that could cause a stroke during the procedure. This minimally invasive treatment is an alternative to traditional surgery when the latter is too risky. The long-term effects of the procedure are still under study.
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Get A Second OpinionCauses
Atherosclerosis, a condition in which plaque builds up in the arteries, is the most common cause of carotid artery disease. A similar buildup occurs in the blood vessels of the heart when someone has coronary artery disease. The plate contains clumps of:
- Cholesterol
- Fat
- Waste from cells
- Protein
- Calcium
Atherosclerosis can make your carotid arteries narrow and less flexible over time. The amount of blood supply to your organs is reduced as a result of this. Other disorders that cause arterial injury can also cause carotid artery disease.
Why is Carotid Angioplasty Performed?
Angioplasty and stenting of the carotid arteries can be effective stroke therapies or preventive options if:
- You have a carotid artery that is 70% or more blocked, especially if you have had a stroke or symptoms of a stroke, and you are not in good health to have surgery, for example, if you have heart disease or severe lung received radiation for neck tumors.
- You have already had a carotid endarterectomy and are experiencing re-narrowing after surgery (restenosis).
- Endarterectomy is difficult to do since the narrowing (stenosis) is difficult to reach.
- In some cases, carotid endarterectomy may be a better option than angioplasty and stenting to remove the buildup of fatty deposits (plaque) that are clogging the artery.
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Book an AppointmentProcedure
Before
This includes over-the-counter medications like aspirin. You may need to stop taking some medications early, such as blood thinners. If you smoke, you will need to stop before the procedure. Talk to your healthcare provider if you need help quitting smoking.
You May Need Some Tests Before The Procedure
- Blood tests, to detect anemia and infection.
- An electrocardiogram (ECG) is used to monitor the rhythm of your heart.
- A chest X-ray, to see your heart and lungs.
- Ultrasound of your neck, to see the carotid artery.
- Computed tomography (CT) angiography of the blood vessels of the neck and head.
Preparation
- You have had a recent change in your health, such as a fever.
- You are or could be pregnant.
- You are allergic to iodine.
- Do not eat or drink after midnight before your procedure.
During the Procedure
- An IV will be placed in your arm or hand before the procedure begins. An IV would be used to administer sedation. This will relax you and make you sleepy during the procedure.
- Hair may be removed in the area of your procedure. The area can be numbed with local anesthesia.
- A minor incision in a blood artery in the groin would be made by the doctor. And, into this cut, you'll put a long-thin cable. During the operation, the wire serves as a reference.
- Next, the doctor will insert a thin, flexible tube (catheter) over the wire. It has a small deflated balloon on the end. The catheter will be passed through the blood vessel to the carotid artery in the neck. Continuous x-ray images can be used to show exactly where the catheter is.
- The balloon will inflate within the narrow part of the carotid artery. This will stretch the open area.
- A mesh tube called a stent is inserted.
- The balloon will be deflated and the catheter will be removed to help hold the region open.
- The groin incision site will be closed and bandaged.
After the Procedure
To avoid bleeding at the catheter insertion site, you must lie relatively still for several hours. You will be in the recovery area or the hospital room. After the procedure, you may have a carotid artery ultrasound. The catheter site may remain tender, swollen, and bruised for a few days. There may be a small area of discoloration or a small lump in the puncture area. You can take acetaminophen (Tylenol, others) in the recommended dose as needed for discomfort, or another medicine prescribed by your doctor. You may need to avoid strenuous activities and heavy lifting for 24 hours after the procedure.
Risk Factors
The risks of this procedure include:
- Infection
- Heavy bleeding
- Arterial injury
- Allergic reaction to contrast material.
- Kidney damage
- Stroke
- Heart attack
- The sudden closing of glasses
- Low blood pressure
- Cardiac arrhythmias, such as slow heart rate
Frequently Asked Questions
Once a stent is placed in a carotid artery, the stent remains permanently within the artery. Once placed, the stent remains permanently within the artery. There is a 2-3% risk that the narrowing will recur if the stent is also blocked in the future. This usually happens within the first 6 to 9 months.
Carotid artery stenting is not a good option for people over the age of 70. The chance of stroke or death during the operation is too high for patients in this age group. Carotid artery surgery (endarterectomy) is usually safer for people over the age of 70.
Carotid artery stenting is a safe and reliable procedure for CR after eversion endarterectomy treatment, with a low rate of post-procedure complications. The type of stent and the cerebral embolic protection device can influence the rate of neurological ischemic events after the procedure.
The procedure is indicated in symptomatic patients with transient ischemic attacks in the carotid territory or minor strokes who have a carotid artery stenosis of 70 to 99 percent.
The condition may go undetected until it is severe enough to starve the brain of blood and cause a stroke or TIA. Signs and symptoms of a stroke or TIA include sudden numbness or weakness in the face or extremities, often on only one side of the body. Sudden trouble speaking and understanding.
It’s permanent. There is only a 2 to 3 percent risk that the narrowing will return, and if that happens, it is usually within 6 to 9 months.
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