Carotid Angioplasty and Stenting

What is Carotid Angioplasty and Stenting?

Angioplasty and stenting are methods used to enhance blood flow within an artery or vein. One prominent example is the carotid artery, a sizable vessel located bilaterally on either side of the neck.

Carotid angioplasty and stenting comprise the carotid artery. During the procedure, doctors utilize a fine tube with a balloon at its tip to open the artery.The carotid arteries send oxygen-rich blood to the brain. A condition known as carotid artery stenosis means that one or both arteries are narrowed. And blood flow to the brain is decreased. This can lead to Stroke. Carotid angioplasty and stenting can aid in reopening these arteries. It is a minimally invasive procedure and non-surgical.

During the procedure, a catheter is put into an artery in the groin. It will be carefully guided up into the affected carotid artery in the neck. The catheter has a miniature, deflated balloon at the tip. The balloon is inflated when it reaches the narrowed portion of the carotid. This opens the narrowed portion. This is referred to as angioplasty.

A miniature mesh tube called a stent may be put into this area. It is left in place to aid in keeping the artery open.

Need of Carotid Angioplasty and Stenting

This procedure may be necessary for individuals experiencing carotid artery stenosis. Carotid stenosis is often caused by plaque buildup on the inside of the artery. This is referred to as atherosclerosis. Certain things can raise the risk of carotid stenosis. These comprise smoking, elevated blood pressure, high cholesterol, diabetes, obesity, and aging.

Some individuals have symptoms from their carotid artery stenosis. These can comprise vision problems or loss of neurologic function in a specific body part. There is also a chance that a blood clot can form in the contracted carotid artery. In case if this blood clot moves to the brain, it can block its supply. This is known as a stroke. It can cause severe harm to the brain and even death.

If an individual has mild carotid artery stenosis, the doctor may give medicines to reduce the risk of Stroke.

If an individual has a more severe blockage, the healthcare professional is more likely to advise a procedure to open the artery. The doctor is also more likely to suggest a procedure if they have already had a stroke or mini stroke.

Carotid angioplasty and stenting are one alternative. Another is a surgery known as carotid endarterectomy. This surgery takes out plaque and any damaged portion of the artery.

Carotid angioplasty and stenting are less invasive. This means it utilizes only a tiny cut. This may lead to reduced recovery times. Also avoids the risks of general anaesthesia. 

Risks of Carotid Angioplasty and Stenting

The risks of this procedure comprise:

• Infection
• Heavy bleeding
• Artery injury
• Allergic reaction to contrast material.
• Renal damage
• Stroke
• Heart attack
• Sudden vessel closure
• Low blood pressure
• Heart arrhythmias
• Return of the blockage

How to Prepare for Carotid Angioplasty and Stenting?

Individuals may require a few tests before the procedure, like:

• Blood tests to detect anaemia and Infection.
• An electrocardiogram (ECG) to check heart rhythm.
• A chest X-ray to observe the heart as well as lungs.
• Ultrasound of the neck to glance the carotid artery.
• And Computed Tomography (CT) angiogram of the blood vessels of the neck and head portion

What Happens During Carotid Angioplasty and Stenting?

A typical procedure may go like this:

• An IV will be put in the arm or hand before the procedure begins. Individuals will be given sedation through the IV line. This will make them relaxed and sleepy during the procedure.
• Hair in the area of the procedure may be removed. The portion may be numbed with local anesthesia.
• The doctor will make a small cut in a blood vessel in the groin. He/she will then insert a long, thin wire into this cut. This wire acts as a guide during the procedure.
• The doctor will then insert a fine, flexible tube over the wire. It has a miniature, deflated balloon on the end. 
• The catheter will be inserted through the blood vessel into the carotid artery located in the neck.
• Continuous X-ray images may depict exactly where the catheter is located.
• The balloon will be expanded within the constricted section of the carotid artery, causing the area to widen.
• A mesh tube known as a stent may be left in place in the area. This will aid in keeping the portion open.
• The balloon will be deflated, as well as the catheter will be taken out.
• The site of incision in the groin will be closed as well as bandaged.

After Carotid Angioplasty and Stenting

After the procedure, the individual will spend several hours in a recovery room. Individuals may be sleepy and confused when they wake up. The healthcare team will watch vital signs, like heart rate and breathing. Individuals will be given pain medicine if they need it.

Individuals may lie flat without bending their legs for several hours after the procedure. This is to aid in preventing bleeding from the incision site. Individuals may be permitted to go home on the same day. Or may need staying in the hospital overnight. 

Individuals may experience slight pain during the procedure. Individuals may notice a bruise where the catheter was inserted. Individuals can take over-the-counter pain medication if he/she needs to. Get some rest and avoid strenuous physical activity for at least 1 day.

In a nutshell, carotid angioplasty with stenting is a minimally invasive and efficient method for addressing carotid artery stenosis, a condition that poses a risk of stroke if not treated. By widening narrowed arteries and reinstating proper blood flow to the brain, this procedure helps diminish the likelihood of stroke and its related issues. While it provides advantages over conventional surgery, it's crucial to recognize and manage potential risks. With thoughtful deliberation and expert medical supervision, this procedure can play a pivotal role in managing carotid artery disease and improving vascular well-being.