Artery Problems & Treatments
The carotid arteries in the neck carry blood from the heart to the brain. Carotid artery disease results from a build-up of plaque in the artery, a condition called atherosclerosis. This blockage can narrow the artery and restrict blood flow, increasing a person's risk of having a stroke. The blockage can worsen over time and eventually completely occlude the vessel which may result in a stroke. The plaque can also become unstable and a piece can break off, travel into a brain artery and into a smaller vessel. The blocked brain artery results in an area of the brain from getting adequate blood supply and oxygen resulting in a stroke.
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Carotid surgery is performed to clear a blockage in the carotid artery and restore blood flow to the brain. Carotid procedures may take the form of an endarterectomy or an angioplasty with stent placement. Surgery is recommended for blockages greater than 70% in asymptomatic patients and for patients with blockages as low as 50% with symptoms.
Carotid Endarterectomy: An endarterectomy surgically removes diseased material and clogged deposits from the inside of an artery to restore normal blood flow.
Carotid Stenting: Carotid stenting involves the implantation of a metal mesh tube (a "stent") to hold a clogged artery open so blood can flow through it unobstructed.
An aneurysm is a bulge in the artery wall. Weakened by atherosclerosis (hardening of the arteries), smoking, hypertension, or other causes, the vessel walls balloon outward with the pressure of the blood flow inside. Typically patients don't know they have an aneurysm because they cause no symptoms. If an aneurysm ruptures, it can cause massive life-threatening internal bleeding. Other risks include thrombosis (clotting) of the aneurysm and embolism. This is when a piece of the inside of an aneurysm can break off, travel through the artery, lodge further downstream and cut off circulation to an area.
An aneurysm can be hereditary. If you have a family history you should be screened.
Aortic Endovascular Stent Grafting: In an endovascular stent-grafting procedure, a small metal cylinder with a synthetic cover called a stent graft is implanted in the artery to provide a strong new vessel wall.
Open Aneurysm Repair: Open aneurysm repair involves making an incision in the abdomen and sometimes in the groin area as well. The aneurysm is opened and a graft made of synthetic material is sewn in place. Hospitalization is typically required for 5-7 days.
Peripheral Artery Disease (PAD)
Peripheral arteries carry blood in the body to the neck, arms, lower abdomen, legs and feet.
Peripheral artery disease (PAD), also known as peripheral vascular disease (PVD), is similar to coronary artery disease and carotid disease. It occurs when peripheral blood vessels are blocked, hardened and narrowed with plaque in a condition called atherosclerosis. This reduced or blocked blood supply may result in symptoms. The diagnosis of PAD increases a person's risk of having a heart or carotid disease.
Peripheral Artery Disease (PAD) Treatment
There are several treatment methods for peripheral artery disease (PAD), ranging from lifestyle changes (e.g. exercise and diet modifications, no smoking, control of blood sugar and blood pressure) and medications (such as antiplatelet drugs, blood thinners and cholesterol-lowering statins) to angioplasty and surgery. Angioplasty procedures are typically percutaneous, which means the procedure is done through a needle stick in the groin blood vessel after local anesthesia is administered. The procedures are usually done as outpatients.
Angioplasty and Stenting: During an angioplasty, a small tube known as a catheter with a balloon on the end is inserted into the blocked artery and gently expanded. This pushes open the blockage and restores blood flow. The catheter is then removed. A tiny metal cylinder called a stent may be put in place to ensure that the artery stays open.
Cryoplasty: In this newer angioplasty technique, the catheter balloon is inflated with nitrous oxide which is freezing cold when the balloon opens the blocked artery and freezes the plaque there. The cold temperature helps to prevent vessel injury and recurrence.
Atherectomy: Atherectomy refers to a percutaneous procedure where plaque from the artery walls is "shaved off" and removed creating a larger vessel opening for blood flow.
Bypass Grafting: This procedure restores circulation by bypassing a blocked vessel-that is, re-routing blood around it. A healthy vein is taken from another part of the body and re-attached, or grafted, above and below the blocked section of the diseased artery. In cases where a vein is not available a synthetic tube is utilized.