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Carotid Artery Stenting

Carotid artery stenting is a minimally invasive procedure used to treat carotid artery stenosis, which is the narrowing of the carotid arteries that supply blood to the brain. The procedure involves the placement of a stent, a small mesh-like tube, to widen the narrowed artery and restore blood flow. Here’s an overview of carotid artery stenting:

  1. Patient Evaluation: Prior to carotid artery stenting, a comprehensive evaluation is performed to assess the severity of carotid artery stenosis and determine if the patient is a suitable candidate for the procedure. This evaluation typically includes a review of medical history, physical examination, and diagnostic imaging tests such as carotid ultrasound, magnetic resonance angiography (MRA), or computed tomography angiography (CTA).
  2. Procedure Setup: Carotid artery stenting is usually performed in a catheterization laboratory or an interventional radiology suite. The patient is given local anesthesia to numb the insertion site, typically in the groin or the arm. In some cases, general anesthesia may be used.
  3. Access and Catheter Placement: A small incision is made, and a catheter is inserted into a blood vessel, usually in the groin. The catheter is guided through the blood vessels to the site of the carotid artery blockage using X-ray guidance (fluoroscopy).
  4. Balloon Angioplasty and Stent Placement: Once the catheter reaches the narrowed segment of the carotid artery, a balloon-tipped catheter is inserted and inflated to widen the artery. This process is known as balloon angioplasty. Then, a stent, which is a metal mesh tube, is placed in the artery to keep it open and improve blood flow. The stent acts as a scaffold, preventing the artery from narrowing again.
  5. Stent Deployment and Post-Procedure Care: The stent is carefully positioned and deployed in the carotid artery. After stent placement, the balloon is deflated and removed. Blood flow is restored through the widened artery. The catheter is then removed, and pressure is applied to the insertion site to prevent bleeding. The patient is monitored for a period to ensure stability before being discharged.

Carotid artery stenting is typically recommended for patients with significant carotid artery stenosis who are considered at high risk for carotid endarterectomy (surgical removal of the plaque). The decision on the most appropriate treatment approach, whether stenting or endarterectomy, is made based on various factors, including the patient’s overall health, the severity and location of the stenosis, and individual risk factors.

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