Why do I need the treatment?
The goal of the carotid stalk is to prevent you from having a stroke in the future. You may have had a TIA (mini stroke). Often times, this is due to a narrowing of the main artery to your brain called the carotid artery in your neck. There is a risk that you will have another stroke in the future. In certain circumstances, even if you have not had a TIA, the specialist involved in your case may recommend treatment for the narrowed carotid artery to reduce the risk of stroke in the future
Preparation for treatment.
Carotid stenting is usually done under local anesthesia. The procedure involves routing small diameter wires and plastic tubing within the arteries under X-ray guidance. These are usually introduced through the artery in the groin called the femoral artery. An injection of an anesthetic into the skin via the pulse in the groin is given and a needle is then used to enter the artery. A wire can be inserted into the artery through the needle. A plastic tube (catheter) is then inserted onto the wire and into the artery.
The wire in the artery is then gently fed to the carotid artery just below the narrowed area. As the wire passes through the narrowed area, you will be carefully monitored by medical and nursing staff to make sure this is not causing any problems. You may be asked to speak or move your hand or arm, and you may be able to follow the progress of the process on a TV screen.
A special catheter is passed along the wire over the narrowed area. This prevents small clots or debris from breaking off the artery wall and getting into the brain, causing more TIAs.
Part of the catheter has a balloon with a metal stent over it. The balloon and stent are carefully placed over the narrowed section of the carotid artery. The balloon is then inflated, expanding the artery. The stent then opens and embeds itself against the arterial wall. At this point, short-term discomfort in the neck can occur.
Some patients feel a little light-headed as the expansion of the artery can cause their blood pressure to drop. If necessary, this can be corrected with fluids and medication given through the drip in your arm.
Once the stent is in place, the balloon is deflated and removed, with the stent supporting the arterial wall and helping to hold it open. Then an x-ray of your neck will be done to check that the narrowed section has been widened successfully and that the stent is in the correct position.
You will be brought back to the train station for observation. Nursing staff will also check your language and movements to make sure they are normal. It is best to rest for the first 1-2 hours. This is in part to help prevent bruising or bleeding in the groin that the catheter was inserted into. The nursing staff will then have you stand up and move around when your observations are satisfactory.
Most people stay in the hospital overnight and go home the next morning. In some cases, you can go home the same day. You can return to normal activities once you are comfortable. Any bruises on your groin will usually go away in 5 to 7 days.
You will usually be sent home with a small dose of aspirin if you are not already taking it. This makes the blood less sticky.
A small number of people, between 1 and 3 in 100 people who undergo a carotid tent, will have a stroke during or shortly after the procedure. All possible precautions are taken to prevent this from happening.
Bleeding that causes a clot around the entry wound in the artery in your groin can occur, but is rarely a problem. This needs to be removed by a small operation 1-2% of the time, but typically the blood is removed from the body over a period of 1-2 weeks.
If you need an angiogram to check stent placement and blood flow, you may be allergic to x-ray dyes. However, this is rare.
If you have other conditions such as angina or bronchitis / asthma, these conditions may worsen at the time of the stent. This rarely causes a major problem.
What can i do to help myself?
If you are a smoker, make a determined effort to quit completely. If you keep smoking, it damages our arteries further and increases the risk of stroke, heart attack and poor blood circulation in your legs.
You can also reduce your risk of vascular disease by reducing your weight, eating a low-fat diet, and exercising regularly.
If you have high cholesterol or high blood pressure, make sure you get it checked regularly and that you are taking the correct medications.
If you have diabetes, be sure to monitor your blood sugar levels. Diabetics are at greater risk of developing vascular disease because of the increased blood sugar levels, which accelerate the formation of furrows in the arteries.