Carotid angioplasty is a treatment for carotid artery disease – a procedure performed on carotid arteries when they become clogged or narrowed by an atherosclerotic plaque. The procedure involves the placement of an antiembolic protection filter past the narrowing, followed by the placement of a nitinol-stent at the level of the narrowing. The stent maintains the artery open and prevents it from narrowing again. Carotid angioplasty is an alternative to open surgery, being used when the traditional surgical procedures are not feasible or pose a high risk.
Peripheral arterial disease (PAD) is a common condition in which a build-up of fatty deposits in the arteries restricts blood supply to leg muscles. It is also known as peripheral vascular disease (PVD).
The fatty deposits, called atheroma, are made up of cholesterol and other waste substances. The build-up of atheroma on the walls of the arteries makes the arteries narrower and restricts the flow of blood to the legs. This process is called atherosclerosis. People with PAD can experience painful aching in their leg muscles during physical activity because the muscles are not receiving the blood supply they need. Like all tissue in your body, muscles in your legs need a constant supply of blood to function properly. When you are using your leg muscles, the demand for blood increases four-fold. However, if the arteries in your legs are blocked, the supply of available blood cannot meet the demand.
The arteries supplying the lower extremities are usually affected, but sometimes the arteries of the upper extremities mey be affected as well. Left untreated, the lesions progress and the tissues supplied by these arteries undergo important, sometimes irreversible impairment.
PAD affects the inferior limbs arteries, but may also affect the neck arteries (carotid arteries), the renal arteries, and those vascularizing the digestive tube (caeliac artery, the superior and inferior mesenteric arteries).
Persons having PAD have not only an increased risk of myocardial infarction and stroke, but may even need aggressive treatment such as limb amputation.
- moderate or severe disease – may improve symptoms, stop disease progression, and avoid amputation.
- high surgical risk patients.
- claudication unresponsive to medical treatment.
- rest pain.
- ischemic skin lesions (i.e. ulcerations).
addBefore procedure - Preparation
The pre procedure assessment establishes what type of treatment is indicated (interventional orsurgical). In order to establish the best treatment option certain exams may be needed, as mentioned above, but the main diagnostic test is the angiography.
Before the intervention, the interventional cardiologist must be prevented of any prior history of allergic reactions to drugs or other compounds, or if there is a suspicion of pregnancy. Current medication must be clearly specified (especially anticoagulant medication –like Sintrom, or antiplatelet drugs – aspirin, Plavix), and any other medical conditions must be mentioned.
There are no absolute contraindications to angiography, but certain precautions will be taken in the case of patients having a severely abnormal renal function.
Sometimes, the cardiologist may recommend antiplatelet therapy before the procedure.
Blood tests are taken (hemoglobin level, coagulation tests, renal function tests, or other specific tests)
The patient is admitted the day before the intervention, and he/she should not eat/drink before the procedure.
addAfter procedure - Recovery time
Since the procedure is minimally invasive, the postprocedural recovery is usually very fast.
After the procedure, the patient is monitored in the intensive care unit, then in the chamber where he/she will be hospitalized. Bed rest is necessary for 12-24 hours (bending of the foot will be prevented to avoid local complications at the puncture site).
The majority of patients can leave the hospital the following day, and they can recommence their usual daily activities (however, physical effort avoidance is recommended for a period of time). Indications about recovery and postprocedural treatment will be clearly specified to all patients before being discharged.
Is it painful?
No. The procedure is made under local anesthesia, so the patient will not feel any pain during the intervention; after the procedure, antialgic medication is administered if needed.
How long does it take?
The whole duration of the procedure is between 1-2 hours and is performed in the catheterisation laboratory.
Next: Read about the Doctors