Stent placement for carotid artery stenosis

Brain stroke or cerebrovascular accident is an increasingly common disease. Previously, the disease was common in the elderly, but now it tends to be younger. There are many causes of stroke, one of which is carotid artery stenosis.

1. What is carotid stenosis?

Bilateral carotid arteries are 2 arteries originating from the thoracic aorta, going along both sides of the neck to supply blood to the entire head and face area. The carotid artery, also known as the common carotid artery, is divided into the external carotid artery, which supplies blood to the entire face and neck, and the internal carotid artery, which supplies blood to the internal brain area.
Carotid artery stenosis is a condition in which the lumen of the artery is gradually narrowing due to plaque buildup on the vessel wall, thereby reducing the blood supply to the brain, leading to symptoms ranging from mild to severe such as transient ischemia to life-threatening. The most dangerous is a stroke.

2. What is the treatment of carotid stenosis by stenting?

Carotid angioplasty is a procedure to widen the lumen of a narrowed artery by inserting and inflating a small balloon right into the narrowed artery, thereby preventing and treating stroke. Carotid angioplasty is often combined with the immobilization of a small piece of metal mesh, called a stent, to keep the artery lumen from narrowing again after angioplasty.
Carotid stenting is considered a less invasive vascular intervention method, the procedure is simple, the preparation time and hospital stay is shorter than that of carotid endarterectomy. If you choose a reputable facility and an experienced doctor, this technique can completely bring about safe and effective results for patients with little effect on the whole body.

3. When should carotid artery dilation and stenting be done?

Carotid stenting is indicated for patients with 70% or more severe carotid stenosis with or without symptoms of cerebral ischemia such as sudden headache, mouth distortion. Difficulty speaking, half body numbness.
In particular, carotid stenting is an effective method in the following cases:
Patients with a history of congestive heart failure, atrial fibrillation, transient ischemic attack or cerebral stroke Young patients Patient had had previous endarterectomy and is now narrowed Patients with inoperable cardiopulmonary disease or chest tumors Difficult-to-operate carotid stenosis

4. What should be prepared before performing carotid stenting?

Before scheduling carotid angioplasty and stenting, your doctor will conduct a thorough examination, learn about your medical history, medical history and current condition, and will perform some necessary tests. .
Carotid ultrasound : An ultrasound probe will be placed in the neck to survey the entire carotid system on both sides, especially the narrow locations, the degree of stenosis. Cerebral angiogram with MRI or CT: electromagnetic waves or X-rays will be used to take detailed pictures of your brain's blood vessels. Digital subtraction angiography DSA: contrast is injected to build the image. your entire detailed carotid system. Blood clotting tests, bleeding The night before the procedure:
Your doctor may adjust some of the medications you are taking if you are taking anticoagulants, diabetes medications. You will completely stop food and drink only small sips of water at least 8 hours before the test. You will be thoroughly cleaned and mentally prepared, resting early to be ready for the procedure.

5. What is the process of stenting to treat carotid artery stenosis?

Carotid artery stenosis stenting begins with the pre-procedural preparation of the patient.
Before the procedure:
The patient is taken to the X-ray room and lying on the procedure table, where there will be tools to help keep your head comfortable and fixed during the procedure. The groin area will be cleaned and injectable reducing medicine You will be hooked up to electrodes to monitor the body's indicators during the procedure During the procedure:
After anesthesia, the doctor will conduct a puncture needle into the femoral artery, and begin the procedure of a carotid dilation and stenting procedure: Place a small catheter into the femoral artery. Then, thread a catheter (catheter) through this guide to the stenosis in the carotid artery under radiographic guidance. Contrast is injected into the catheter to the carotid artery, which shows the carotid artery and blood to the brain on a monitor. Place a parachute-shaped filter that is threaded over the narrowed artery, which is used to capture the ruptured plaque from the narrowing to prevent embolism. Insert the balloon to the narrowed carotid artery and begin inflating to widen the artery and squeeze the atherosclerotic segment against the vessel wall. Place a small metal mesh (stent) about 2 to 4 cm over the site of the aneurysm. The inflated stent acts as a fixed frame, keeping the lumen from narrowing again after angioplasty. Finally, remove the filter, catheter, and catheter through the femoral artery as at entry and stop the bleeding. Once completed, you will be taken to the recovery room. During the procedure, you will not feel the movement of the catheter or guide because there are no nerves in the vessel. However, you may feel a burning sensation when the contrast is injected. During the procedure, there will be no pain or discomfort. After the procedure:
Possible complications: The needle puncture site may be swollen, hot, red, painful, or infected if not thoroughly sterilized. There may be slight changes in skin color or calluses. If you are concerned, you should inform your doctor for treatment. You also need to avoid strenuous work or lifting heavy objects for 24 hours after the procedure.

6. Results of stent placement for carotid artery stenosis

For most patients, stenting restores blood flow through the stenosis, ensures cerebral blood supply, reduces symptoms of transient ischemic attack, and prevents stroke.
However, carotid stenting is not the only method for treating carotid stenosis and should be carefully reviewed by a physician prior to preparation and scheduling. So don't be afraid to visit your doctor for the best advice.
Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, modern equipment and technology, but also stands out for its examination and consultation services. comprehensive and professional medical consultation and treatment; civilized, polite, safe and sterile medical examination and treatment space. Customers when choosing to perform tests here can be completely assured of the accuracy of test results.

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Bài viết này được viết cho người đọc tại Sài Gòn, Hà Nội, Hồ Chí Minh, Phú Quốc, Nha Trang, Hạ Long, Hải Phòng, Đà Nẵng.

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