CAROTID & VERTEBRAL ANGIOPLASTY /STENTING
Carotid and vertebral arteries are major blood vessels supplying blood to your brain and head. They run along either side of your neck (carotid) and up through your spine (vertebral). When fatty deposits (plaque) build up in these arteries, they narrow, reducing blood flow to the brain – a condition called carotid artery disease (CAD) or vertebral artery stenosis. This raises the risk of stroke.
Carotid angioplasty and stenting is a minimally invasive procedure to address CAD and prevent strokes. Here’s how it works:
- A thin, flexible tube (catheter) is inserted into an artery in your groin and threaded up to the blockage.
- A tiny balloon at the catheter tip is inflated to widen the narrowed artery.
- Often, a small metal mesh tube (stent) is placed to hold the artery open and prevent re-narrowing.
IR (Interventional radiology) treatment plays a key role in this procedure. IR specialists use X-ray imaging during the procedure to guide the catheter and balloon precisely.
Benefits of Angioplasty/Stenting:
- Minimally invasive compared to traditional open surgery (carotid endarterectomy).
- Quicker recovery time.
- Often performed as a day procedure.
Who is a candidate?
This procedure is not suitable for everyone. Doctors consider factors like:
- Severity of blockage
- Location of blockage
- Overall health
Detailed Procedure Breakdown:
Pre-Procedure: This phase involves a thorough medical evaluation. Imaging tests like CT angiography or carotid artery ultrasound pinpoint the blockage location and severity. Your doctor will discuss the procedure, risks, and alternative options like carotid endarterectomy (surgical removal of plaque).
Catheter Insertion: Under local anesthesia, the IR specialist inserts a catheter through a small puncture in the groin artery. Using fluoroscopy (live X-ray imaging), they guide the catheter through blood vessels to the blocked artery.
Angioplasty: A balloon catheter is positioned within the blockage. Inflation of the balloon widens the narrowed artery to improve blood flow.
Stenting (Optional): Following angioplasty, a stent may be deployed to hold the artery open and prevent future narrowing. The stent is delivered through the same catheter and expands within the artery.
Catheter Removal and Closure: Once the procedure is complete, the catheter is removed, and the groin puncture is closed with a pressure bandage.
IR Advantages for Carotid Artery Disease:
- Carotid Artery Stenting with Embolic Protection Devices: During angioplasty, a temporary filter is placed upstream to capture any debris dislodged while opening the blockage, preventing it from traveling to the brain and causing a stroke.
Recovery and Follow-up:
- Most patients go home after a 24 hour observation in ICU.
- Aspirin or other blood thinners might be prescribed to prevent blood clots.
- Regular follow-up appointments with your doctor are crucial to monitor the artery and ensure it remains open.
Additional Considerations:
- Success Rates: Carotid artery angioplasty/stenting has high success rates for opening blocked arteries. Long-term benefits in reducing stroke risk depend on individual factors.
- Risks and Complications: While minimally invasive, potential complications are very rare include stroke, bleeding, allergic reaction to contrast dye, and kidney problems.
- Comparison with Carotid Endarterectomy: Both procedures aim to prevent strokes. The choice depends on the blockage location, anatomy, and patient’s overall health.
Conclusion:
Carotid & vertebral angioplasty/stenting with IR guidance provides a minimally invasive option for treating blocked arteries and reducing stroke risk. It’s crucial to discuss the procedure, risks, and alternatives with your doctor to determine the most suitable approach for your specific situation.
