What is a carotid artery?
There are two carotid arteries in the human body, a left and a right. They run on either side of your neck towards the brain and face. Both carry blood from the heart and are essential for oxygen to reach the brain. A carotid occurs when there is blockage within one of the arteries, making it difficult for blood to reach the brain and face.
Why does carotid disease occur?
There are two types of carotid blood flow interuptions; atherosclerosis and stenosis. Atherosclerosis is the build up of fatty substance on the wall of the artery called plaque. This is also known as ’hardening of the arteries’. Stenosis is the narrowing caused by plaque in the artery.
Plaque has the potential to partially block the artery by making it narrow or close the artery completely. There are certain side effects to having a carotid artery, such as;
- A stroke, particles of plaque and blot clots can dislodge and travel up the brain, causing a stroke. A stroke occurs when blood stops flowing to part of the brain.
- An embolism, which is a blood clot being formed and traveling to the brain. It will prevent blood being pumped to that section of the brain.
- A thrombus, where a clot forms over the plaque preventing blood being pumped to the brain or face.
How is carotid disease treated?
There are two different surgeries for a blocked carotid artery. The first is a carotid endarterectomy, this surgery entails the artery being cut open and the plaque removed.
The second is a cardio angioplasty and stent. An angioplasty and stent includes a catheter being inserted directly to an artery from the groin, a balloon is expanded in the artery and the stent is put in place to keep the artery open.
Both surgeries are effective, however some are more appropriate than others, it depends on the patients’ individual circumstances. The specialist will discuss which is best suited to the situation.
Carotid Endarterectomy
A carotid endarterectomy is the removal of the plaque from the artery.
The surgeon will clamp the artery above and below the plaque to be removed. The artery is opened with a small incision. The surgeon carefully cuts and peels plaque away from the inside wall of the artery.
Once the plaque has been removed the artery is closed using sutures. On occasion a patch may be used to close the artery.
The clamps are removed from the artery and the incision on the neck is closed with dissolvable stitches.
Carotid Angioplasty Stenting
Carotid angioplasty stenting is the opening of the artery with a balloon and inserting a stent to keep the artery open.
What is an endovascular stent?
An intravascular stent is a small metallic tube that is placed on the balloon catheter and introduced into the blocked artery. The stent is gently expanded by inflating the balloon, to open the vessel, restore blood flow and relieve symptoms. The stent remains in the vessel as a permanent implant.
How a Stent is Inserted?
The stent is placed on the balloon catheter and directed to the blocked area of the vessel.
Once the balloon and stent are in the correct position, the balloon is inflated, causing the stent to open. One or more stents may be expanded in the vessel.
The stent will remain in place permanently keeping the vessel open.
The healthy lining of the vessel will slowly grow over the stent, making it a permanent part of the vessel wall. The stent will not usually limit any of your normal activities.