When is carotid artery stenting the right choice for stroke prevention?

The human body is a complex system, and the carotid arteries, positioned on either side of the neck, play a crucial role in maintaining brain health by supplying oxygen-rich blood. However, when these arteries become narrowed due to fatty deposits, it leads to a condition known as carotid artery disease, which can significantly increase the risk of stroke, one of the world’s leading causes of death and disability. Understanding when to opt for carotid artery stenting could be life-saving for many, says health cover provider Affinity Health.

Recognising the symptoms

In the early stages, carotid artery disease can develop unnoticed, leaving individuals unaware of the dangers lurking beneath the surface. Transient ischaemic attacks (TIAs), often termed “mini-strokes,” serve as a critical warning sign. Symptoms to be aware of include:

• Sudden weakness or numbness in the face, arms, or legs, particularly on one side of the body
• Difficulty speaking or understanding speech
• Sudden vision problems
• Dizziness or difficulty walking
• Severe, unexplained headaches

If you or someone you know experiences these symptoms, seeking emergency medical care is imperative.

Understanding carotid artery stenting

Carotid artery stenting is a minimally invasive procedure designed to treat narrowed or blocked carotid arteries. This innovative approach involves inserting a thin tube, known as a catheter, through the groin and using a small balloon to widen the narrowed area. A stent, a tiny mesh tube, is then placed inside the artery to maintain its openness. The goal is simple: restore vital blood flow to the brain and stave off the risk of stroke without the need for more invasive surgery.

When is a stent the best option?

Doctors may recommend carotid artery stenting based on specific criteria:

• Moderate to severe narrowing: If the artery is more than 70% blocked and symptoms such as a TIA or minor stroke have occurred.
• High surgical risk: For patients who may not tolerate open surgery well due to age, underlying health conditions, or previous neck surgery.
• Anatomical factors: When blockages are located in areas that are challenging to access through traditional surgery.
• Emergencies: Situations where urgent blood flow restoration is necessary to avert a major stroke.
• Preference for faster recovery: Patients desiring less invasive procedures with quicker recoveries may find stenting more appealing.

Weighing risks and considering alternatives

As with any medical procedure, carotid artery stenting comes with its own set of risks, which may include stroke during or after the procedure, bleeding or infection at the catheter site, re-narrowing of the artery, or the formation of blood clots around the stent. Healthcare professionals assess each patient's unique risk factors meticulously before recommending this treatment. In some instances, carotid endarterectomy (CEA) — a more traditional surgery to remove plaque — remains the standard treatment. For those with only mild narrowing, lifestyle changes and medication may be sufficient to manage the condition and lower stroke risk.

Prevention through lifestyle choices

Preventive measures against carotid artery disease often hinge on making healthy lifestyle choices. Adopting a heart-healthy diet, engaging in regular exercise, quitting smoking, managing chronic conditions like high blood-pressure or diabetes, and maintaining a healthy weight can significantly reduce risk.

The importance of early detection

Proactive screening methods, such as ultrasounds, CT scans, or MRIs, can identify narrowing before symptoms arise. Individuals at risk — due to obesity, high blood-pressure, smoking, or a family history of heart disease — should discuss testing options with their healthcare providers.

Empowering health decisions

Carotid artery stenting presents an important, potentially life-saving intervention for those at high risk of strokes stemming from narrowed arteries. While not suitable for everyone, timely recognitions of warning signs, regular health check-ups, and engaging in discussions related to treatment options with healthcare professionals are vital steps towards safeguarding one’s health. In the long haul, maintaining a heart-healthy lifestyle remains critical for prevention. 

IOS