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Tell Me About...Carotid Artery Stenting with Dr. Sinnathamby

Stenting Opens a Blocked Carotid Artery

Dr. SinnathambySukirtharan Sinnathamby, MD, is with Buckeye Heart and Vascular Institute.

What happens when a carotid artery is blocked?

The carotid arteries – there is one on each side of the neck – bring oxygen-rich blood to your brain and face. Blood flow in a carotid artery can become partly or totally blocked by plaque, which is the same fatty material that clogs arteries in your heart. Over time, accumulated plaque may block a carotid artery enough to cause a stroke.

How do you know if a carotid artery is blocked?

Blockage in a carotid artery may cause stroke-like symptoms – headache, dizziness, tingling, numbness, blurred vision, confusion or paralysis – that can last anywhere from a few minutes to a couple of hours. These transient ischemic attacks are often called TIAs or mini-strokes. See a doctor right away if you or someone you know experiences a TIA.

Other symptoms of carotid artery blockage include trouble swallowing and blurry sight in one eye. It is also possible to have carotid artery disease with no symptoms. Your doctor may detect the condition when listening to the blood flow in your neck through a stethoscope. Blood makes an unusual sound called a bruit when it rushes past an obstruction in an artery. X-ray studies using special dyes (carotid angiogram) as well as ultrasound and MRI scans can show the degree of blockage.

What are the treatment options?

Your doctor may prescribe dietary changes and medication to lower your cholesterol and help prevent the formation of plaque and blood-thinning medication to lower your risk of stroke. If the blockage is severe, your doctor might recommend surgery to remove the blockage (carotid endarterectomy) or carotid angioplasty with a stent.

What is angioplasty with a stent?

In this procedure, which is done under local anesthetic, the doctor makes an incision in your groin and inserts a catheter (a flexible tube) through this incision into an artery. Using real-time x-ray images as a guide, the doctor carefully threads the catheter up to the carotid artery blockage in your neck. The catheter has a filter, a small balloon and a stent (a thin, wire mesh tube) attached to the end. The filter is placed in the artery to catch any debris that may be released during the procedure. When the balloon is inflated, it presses against the inside wall of the artery, flattening the plaque and opening the vessel. This part of the procedure is called angioplasty.

When the balloon is inflated, the stent expands as well. It is left in place to keep the artery open and blood flowing to the brain when the balloon and filter are removed. The smooth lining of the artery wall eventually covers the stent and secures it in place permanently.

How long is the recovery period?

Patients are observed for several hours after the procedure, which is done on an outpatient basis. Some patients will require further observation and an overnight stay. Most people feel fine in a matter of days following the procedure.

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