Carotid Artery Stenting
The carotid arteries supply vital blood flow from the heart to the brain, face and scalp. There are two carotid arteries, one on each side of the neck. Each carotid artery has an internal branch that supplies blood directly to the brain, and an external branch that nourishes the face and scalp.
If there is a narrowing of the carotid artery due to plaque (material that builds up on the inner surface), blood clots can form and prevent blood from reaching the brain. The result could be a stroke, which can cause paralysis, brain damage and even death. Also, small clots breaking away from the plaque can block smaller vessels and cause mini-strokes, known as transient ischemic attacks (TIAs). TIAs or strokes can cause symptoms such as partial blindness, weakness of limbs, skin tingling and numbness. Patients who have had a TIA have a higher chance of suffering a stroke.
Stenting involves the use of a flexible catheter to widen a carotid artery that has narrowed due to plaque buildup. Before the procedure, patients are given a sedative (but are not put to sleep), and are given medications to prevent blood clots.
The catheter is usually placed into an artery in the arm or groin and gently guided into the carotid artery with the aid of live x-ray images (fluoroscopy). A contrast substance is injected into the bloodstream at the blockage so the physician can see the blood flow on an x-ray monitor. A balloon on the tip of the catheter is expanded to open the plaque-clogged area of the artery. A stent - a tubular-shaped metal mesh support or mini scaffold - is then expanded to keep the artery propped open. Before angioplasty and stenting are performed, cardiologists also insert a small filter-like protection basket to catch any loose clots from entering the brain that could cause a stroke.
Although carotid artery surgery (endarterectomy) is still the preferred method of treating narrowed carotid arteries and removing blockages in many patients, stenting is performed on patients for whom surgery would present too many risks. Such patients include those with advanced age, major illnesses, advanced heart disease such as congestive heart failure, arrhythmias, a completely blocked carotid artery, and those having undergone a previous endarterectomy.
Complications and risks, although rare, can include the following:
- Potential stroke because of a small blood clot or plaque material breaking off during or immediately after the procedure
- Plaque eventually rebuilding around the stent (restenosis)
- Tearing of the artery wall by the catheter
- Allergic reaction to the iodine-based contrast used during the procedure
- Contrast causing damage to the kidneys in patients with kidney disease
MDCA cardiologists perform these procedures in a full catheterization laboratory using state-of-the-art heart catheter equipment. They are experienced in assessing the full spectrum of heart conditions, and use cardiac catheterization as an important tool to assess a patient's overall heart health and to direct his or her treatment. To make an appointment with an MDCA cardiologist experienced with carotid artery stenting, please call 713-441-1100 (Pearland patients, please call 713-441-9909).