CAROTID ARTERY ANGIOPLASY AND STENTING

Stroke is the third leading cause of death in the United States and the leading cause of serious, long-term disability.  Approximately 70% of all strokes occur in people age 65 and older.

The carotid artery is located in the neck and is the principal artery supplying the head, brain, and neck with blood.  Plaque (or cholesterol, fatty, and calcific deposits) can accumulate in this artery, resulting in decreased blood flow to the brain.  This plaque can also break free into small or large pieces which will lodge in other arteries in the brain, thereby causing stroke.

The current standard of care for blockage of the carotid artery is an open surgery called carotid endarterectomy.  This involves an incision in the neck and subsequent incision in the artery to clean out the debris.  The result is removal of the blockage and improved blood flow to the brain.  By removing the debris, this decreases the risk of plaque breaking free and causing stroke.  The risk of stroke with the open procedure is about 2-3%.

The new procedure of carotid artery stenting involves placing a needle and catheter in the artery in the groin.  The catheter in the groin is then pushed up the the blocked artery in the neck.  Xray is used during the procedure to place the catheter in the correct position.  Once the catheter is positioned appropriately,  the physician places a wire across the area of blockage in the carotid artery.  A balloon-like device is then passed over the wire into the blockage and inflated, so as to re-open to artery.  Next, a stent (or metal mesh-like device) is then placed in the artery to prevent it from closing and from allowing pieces of plaque to enter the bloodstream.  The risk of stroke during this procedure is about 4%.

Recently,  Medicare has approved this new surgical procedure if a patient meets specific criteria.  The physicians at Vascular Health Center do perform this new, less invasive procedure, as well as, the open carotid artery procedure.