Carotid intervention to prevent stroke

Catch strokes before they catch you

Angiography shows cartoid stenosis
Angiography shows cartoid stenosis
Carotid angioplasty filter
Carotid angioplasty Filter
Carotid endarterectomy
Carotid Endarterectomy
Excised carotid plaque
Excised Carotid Plaque
PTFE patch
PTFE Patch

Blockage in the carotid artery in neck is a common and important cause for development of brain stroke or paralysis, a potentially disabling and often life-threatening condition. The role of vascular specialist in removing this blockage is vital in the prevention of stroke. The causes or risk factors for blockage in carotid artery are similar as those for heart blockage or leg artery blockage.

What are symptoms of blocked carotid arteries?

Weakness or numbness on one side (leg, arm or face), slurred speech or visual disturbances are the usual presenting symptoms of mini-stroke. Even if these events last for a few minutes or hours, they could be warning signs of carotid blockage and an impending stroke.

They need to be evaluated by a carotid doppler test which is a simple non-invasive sonography of neck. A confirmatory angiography or CT angiography is done if intervention is planned.

Patients with high blood pressure, diabetes and cholesterol or past heart problems should also undergo a baseline carotid doppler test.

What are the treatment options?

Minor blockages (less than 50 %) are treated by blood thinner and cholesterol controlling medicines. If blockage is more than 50 or 60 %, then surgery or angioplasty with stenting is recommended.

Carotid endarterectomy is a special surgical operation for removal of the carotid artery blockage. We routinely perform this procedure under a loco-regional anesthesia so that intra-operative neurologic monitoring is easy. The artery is opened and the plaque carefully removed. During this operation, we use a shunt to maintain blood flow to the brain. The artery is then repaired using a vein or graft patch to prevent narrowing.

The other treatment option we offer is carotid angioplasty with stenting under protection device. These protection devices prevent small plaque particles to dislodge to the brain during stenting and thus the complications of this procedure is reduced to less than 3%. It is mainly performed for high-risk patients or those with high carotid bifurcation.

Can a major stroke be prevented?

If the blockage is detected and treated successfully in time, the further chances of a major stroke are minimized.

Can this procedure utilized to treat stroke?

Once a patient develops stroke, some permanent damage would already have occurred in the brain. So this treatment will not cause significant improvement in the problems. This is why it is very essential to treat carotid blockage before a major stroke strikes you!

Vascular specialists provide care to patients with diseases or disorders of their blood vessels except the heart or brain. There are very few surgeons in India, trained in this specialty. -Dr. Sumit Kapadia

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