Some patients who are at risk for stroke may not be candidates for conventional surgery to unblock the arteries for a number of reasons.
Local Interventional Cardiologist Dr. Amir Haghighat says, "They may have heart disease or severe lung disease. They may have had prior radiation to their neck or other reasons why surgery may be very difficult for them."
Those patients may fair better with carotid stenting, because it doesn't require general anesthesia and it's a quick procedure. It's done in about 15 to 20 minutes in a cath lab and only involves overnight hospitalization.
Carotid stenting is done through a tiny needle hole in the groin. It involves temporarily inserting and inflating a tiny balloon to widen the clogged artery, much like stenting for blockages to the heart.
Dr. Haghighat says, "The difference between the heart and the brain is that the brain is much more susceptible to any small embolic phenomenon. So any little piece can go up to the brain and cause a bad problem, so what we use in carotid stents is a little filter. It stays there during the case and protects any pieces from going up north, so it basically catches any debris as you work, and then it's retrieved back into the catheter and removed out of the body."
The stent -- a small metal coil -- is inserted into the clogged artery to help prop the artery open and decreases the chances of it narrowing again.
If you think you may be at risk for stroke your doctor can actually listen to your neck to see if there's a "bruee," a whishing sound which is a tale-tell sign of problems.
Bay Medical Center Cardiology associates are now enrolling patients in a registry to monitor the success of their program. The government is requiring hospitals to have the registry to be able to provide the carotid stenting procedure to both high risk patients and others who are asymptomatic.
Bay Medical is one of the few sites in the region to have that registry in place. It's an independent assessment of neurological outcomes in all the patients who undergo stenting. The patients are interviewed by someone not associated with the hospital the day before the procedure, the day after, and 30 days after to see if there were any complications.
Dr. Haghighat says over the last two years they've enrolled 60 patients in the registry. All have been success stories.