Carotid stenting

Atherosclerosis is a systemic process that affects all arteries in the body. Atherosclerosis results in the formation of plaques. If atherosclerotic formations or plaques develop in the carotid arteries, the blood flow to the brain may be blocked, leading to a stroke. To prevent this from happening, carotid artery stenting is performed. This procedure is based on the implantation of a stent in the lumen of the carotid artery affected by atherosclerosis in the form of a small tube, which will be a new framework for the affected vessel.

If the internal carotid artery becomes blocked, an ischemic stroke will occur. In addition, small pieces of atherosclerotic plaque in the carotid artery can break off and block the blood vessels in the brain, also causing a stroke. The surgery to insert the stent is called carotid stenting.

At the Academic Cardiology Clinic of the Ludwig-Maximilians-Universität München, the doctor schedules a vascular ultrasound scan, computed tomography or magnetic resonance imaging and, if necessary, angiography a few days before the surgical intervention.

These studies can determine the size and length of the affected area, the exact localization of the lesion, as well as blood flow velocity and other parameters.

In milder cases, endarterectomy — removal of the plaque — is performed, but if the case is longer and more advanced, then carotid stenting is performed.

The procedure is performed under local anesthesia, however, if the anesthesiologist determines the indications, it can be performed under intravenous anesthesia, the patient is in a shallow sleep. Before the procedure, the doctor connects the patient to a monitor that displays respiratory and hemodynamic parameters.

At the «Heart Center», depending on the anesthesia, surgeons may ask the patient to perform some tasks to periodically check brain function, or the surgery is performed under general anesthesia.

Stenting consists of the following steps.

• Heparin is injected intravenously, after which the puncture site is anesthetized.
• Next, an angiographic study is performed to show the location of the narrowing. Usually the femoral artery or upper limb vessels are the vessel to be catheterized.
• A balloon catheter is inserted into the vessel.
• With continuous radiographic contrast, the balloon is brought to the site of narrowing.
• Next, the balloon is inflated and followed by the insertion of a stent, which expands at the site of the atherosclerotic plaque, causing the artery to dilate.

Cost of services

carotid stenting