A carotid angioplasty is a surgical procedure that is helpful in unblocking a clogged carotid artery. This surgery is also useful in treating a stroke and works by restoring the affected blood supply in the damaged carotid artery.
A carotid artery is one of the two arteries situated at both sides of your neck and is the main artery that supplies blood to the brain. A blockage in any of these arteries results in lack of adequate blood supply to the brain and this can cause various complications, including stroke or even death.
Carotid angioplasty uses a minimally invasive surgical method in order to enlarge the artery and help restore the blood supply in it. This procedure is often accompanied with an additional procedure which involves implanting a small metal mesh-coil (stent) in the affected artery to help it regain the enlarged width. This helps to keep the treated carotid artery enlarged and also to avoid the chances of another blockage occurring in the artery again.
Need for Carotid Angioplasty
Carotid angioplasty and stenting are considered ideal stroke treatment methods as well as adequate stroke prevention methods, if:
- Your carotid artery is more than 70% blocked and if you have had a stroke, or stroke-like symptoms, and you are not in a healthy condition to undergo a surgical treatment.
- You have had a carotid endarterectomy prior and are still experiencing narrowing of arteries after surgery (restenosis).
- The restenosis (narrowing) is located in a difficult-to-reach position using an endarterectomy procedure.
Risks associated with Carotid Angioplasty
As is seen in any of the major surgical procedures the carotid angioplasty and stenting procedure also may entail certain risks, such as:
- Stroke/mini-stroke – During the angioplasty procedure the blood clots that may form on the catheters can break loose and travel to your brain through the carotid artery itself. Blood thinners are used during the procedure in order to prevent blood clots. A stroke may also occur when the plaques inside the artery gets dislodged as the catheters are threaded through the arteries.
- Restenosis – This condition arises when the treated artery starts getting narrowed again (restenosis). Stents are used to avoid this complication.
- Blood clots – Blood clots can form within the stents after a few weeks or months from an angioplasty. These clots are at a risk of causing a stroke or, even, death. Blood thinners are regularly used to prevent this risk.
- Bleeding – You may experience bleeding at the incision site but this stops on its own after some time.
Carotid Angioplasty (and Stenting) procedure
A carotid angioplasty is a minimally invasive surgical procedure and uses small and flexible tubes (catheters) to perform the required tasks during the surgery. The incisions required for this surgery are very few (2-4) and very small (keyhole) as compared to the conventional open-type of angioplasty method.
The surgeon will usually administer local anesthesia to numb the incision area and make the required incisions on the artery, mostly the femoral artery in the groin region.
The next step involves inserting a tubular sheath into the artery and holding it in place. This entry point is used to then insert a catheter into the carotid artery while viewing it and guiding it using advanced x-ray imaging guidance technology.
A contrast material is then injected into the carotid artery using the catheter. This helps provide a clearer view of the narrowed artery and the blood supply to the brain.
The surgeon will then fit an umbrella-shaped filter (embolic protection device) in artery beyond the narrowed portion of the artery. This device is helpful in catching any type of debris that may get dislodged from the narrowed portion of the artery during the procedure.
The surgeon will use another catheter, this one with a deflated surgical balloon at the end, and insert it into the artery till it reaches the narrowed point of the carotid artery. When the surgeon is satisfied that the balloon is placed as required he will start to inflate and deflate the balloon a few times. This helps to widen the narrowed portion of the artery in a gradual manner.
After the narrowed artery is sufficiently widened, the surgeon will then place a small metal-mesh tube called a ‘stent’ in the newly-widened portion of the artery. The expanded stent provides support and stabilizes the artery walls from collapsing and getting narrowed again.
After the stent is fixed firmly in place the surgeon will carefully remove the catheter as well as the tubular sheath from the incision in the groin and close the incision using very small sutures to prevent bleeding.
Carotid angioplasty at affordable cost with stenting has proven to be an ideal method of treatment for narrowed carotid artery as well as preventing stroke and other stroke-related symptoms by .