It is performed along with carotid angiography, which uses X-ray images to check for the narrowed carotid arteries. Carotid arteries are the arteries in the neck that supply blood to the brain. Carotid artery disease condition occurs by atherosclerosis, which is deposition of fatty material or plaque in the walls of carotid arteries.
The fatty material thickens and becomes hard blocking the blood to flow within these arteries causing nerve cell death and stroke as a lack of oxygen to brain cells.
You may be at higher risk of developing carotid artery disease if you have the following factors such as
- Family history
- Inactive lifestyle or obesity
- Diabetes
- High blood pressure and high cholesterol
- Smoking
Symptoms
The symptoms do not develop at early stages of development. The most common symptoms include:
- Weakness and numbness in arm or legs on one side of body
- Slurred speech
- Headache
- Loss of vision in one of the eyes
- State of confusion
- Stroke
Diagnosis
- Carotid duplex ultrasound – An ultrasound is placed over the carotid arteries to check for blood flow within the arteries
- CT and magnetic resonance angiography (MRA) provide detailed images of the blood flow in the carotid and intra-cranial vessels and allow a detailed evaluation of the brain.
Procedure
Carotid stenting is indicated for hemodinamically significant stenosis or for unstable plaque and it is an alternative to open surgery (carotid endarterectomy). The endovascular treatment is planned with the Angio-CT (evaluation of the best vascular access, choice of the materials, stent dimensions).
Once the local anesthetic is administered, a puncture of the common femoral artery at the groin is performed under ultrasound guidance. A thin catheter is then advanced into the common carotid artery and dye in injected to perform an angiogram that allows to localize the internal carotid stenosis (narrowing).
The intracranial vessels (blood vessels of the brain) are protected by endovascular clamping or filters to avoid distal embolization.
The stent covers the carotid narrowing causing flattening and “trapping” of the plaque against the arterial wall with restoration of the normal arterial caliber and flow to the brain.
The stent stays within the artery; no scars will be visible at the groin.
The procedure lasts about 30 minutes and the patient is usually discharged home the following day.
Risks & Complications
Complications that may occur during or after carotid stenting procedure includes:
- Re-stenosis, re-accumulation of plaque narrowing or blocking the carotid artery again.
- Distal embolisation during the procedure if brain protection devices are not used; however, endovascular clamping or filters are always used.