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1. Access to Vascular
A sheath is inserted into a major artery by making a little incision in the arm, wrist, or groin.
Carotid Stenting
Carotid Stenting
procedure steps
2. Navigation of Catheters
The constricted carotid artery in the neck is reached by passing a catheter via the arterial system under fluoroscopic supervision.
3. Imaging and Angiography
To see the carotid artery and the precise position and degree of the stenosis or occlusion, contrast dye is injected.
4. Placement of Embolic Protection Devices
In order to protect the brain and catch any material that might come loose during the treatment, a filter device is placed outside of the constricted area.
5. Angioplasty with balloons
In order to compress the plaque and widen the artery, a tiny balloon catheter that has been deflated is inserted into the constricted segment and inflated.
6. Deployment of Stents
In order to scaffold the artery open and prevent restenosis, a metal mesh stent is introduced to the treated area and expanded (either self-expanding or balloon-expandable).
7. Post-dilation
To guarantee ideal apposition against the vessel wall, a balloon may be reinflated inside the stent.
8. Removal of the Catheter and Embolic Protection Device
To stop emboli from getting to the brain, the filter device and catheters are gently removed.
9. Recuperation and Hemostasis
To halt bleeding, either a closure device or pressure is administered to the access point. The patient's neurological condition and any problems are tracked.
disease treated
Ischemic Stroke
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Carotid Artery Stenosis
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suitable for
Individuals with Carotid Artery Stenosis Symptoms
Usually, 50% or more stenosis results in a brief ischemic event or small stroke.
Individuals with Carotid Artery Stenosis Without Symptoms
≥70% stenosis is typically associated with a high risk of surgery or less invasive treatment.
Candidates at High Surgical Risk
Individuals who are not good candidates for carotid endarterectomy because of their age, comorbidities, or history of radiation or neck surgery.
Advantageous Anatomic Standards
Aortic arch type I or II, suitable vessel sizes and angles, and the lack of significant calcification or tortuosity are all examples of ideal vascular anatomy.
Age-Related Issues
It is usually recommended for patients under 80, however certain elderly patients with a high risk of surgery may be eligible.
Contraindications
Patients with significant vascular tortuosity, cerebral bleeding, inability to tolerate antiplatelet therapy or other contraindications should not use this medication.
benefits
Decreased Risk of Stroke
Carotid stenting dramatically lowers the risk of stroke in patients with carotid artery disease by enlarging the constricted carotid artery and stopping additional plaque-related blockages.
Minimally Invasive method
Compared to conventional carotid endarterectomy surgery, this method utilizes tiny incisions, usually in the groin or wrist, and results in less pain, shorter hospital stays, and quicker recovery.
Avoiding General anesthetic
Local anesthetic and light sedation are typically used for carotid stenting, which lowers the hazards of general anesthesia.
Ideal for Patients at High Risk for Surgery
For patients who are not good candidates for surgery because of their age, comorbidities, prior neck operations, or radiation therapy, this is an option.
Reduced Risk of Nerve Injury
Carotid stenting is less likely to cause damage to the neck’s cranial nerves than open surgery.
Shorter Recovery Time
Due to less invasiveness and speedier healing, patients are able to resume their regular activities more quickly.
Long-Term Effectiveness
Research indicates that restenosis rates and long-term stroke prevention efficacy are comparable to those of carotid endarterectomy.
post-treatment recovery
Hospitalization and Prompt Monitoring
Entails a 24- to 48-hour hospital stay for careful observation of vital signs, neurological condition, and access site for problems like bleeding.
Limitations on Activities
For one to two weeks, refrain from heavy lifting (more than twenty pounds) and intense activities to promote vascular access site healing and minimize problems
Care of the Incision Site
Keep the access site dry and clean, and keep an eye out for any discomfort, swelling, or infection-related symptoms.
It is common to experience some bruising or pain at the puncture site, which normally goes away in a few days.
Drugs
To avoid stent thrombosis, antiplatelet therapy (aspirin plus another medication, such as clopidogrel) is recommended for a minimum of one month, and frequently longer depending on patient characteristics.
Following prescription regimens is essential.
Lifestyle and Rehabilitation
Promote a gradual return to regular activities and cardiovascular workouts, such as walking.
It is crucial to change one's lifestyle in order to manage risk factors like blood pressure, cholesterol, quitting smoking, and diabetes.
Follow-Up Examinations
Particularly within the first 24 months following the surgery, routine Doppler ultrasonography follow-up is advised to check for in-stent restenosis.
Signs to Watch For
