Our group (Dr. Shah & Dr. Babu as surgeons along with Dr. Mateo & Dr. Pucillo as interventionalists) has been approved to participate in a NIH sponsored multicenter trial, (CREST - Carotid Revascularization; Endarterectomy and Stent Trial)
Carotid Artery Stenosis
Carotid artery stenosis is one of the major causes of stroke or TIA. The carotid artery is the vessel that supplies blood to the brain and face. The artery becomes narrowed or blocked by a gradual build-up of fat within the artery wall, which reduces blood flow to the brain. This build-up is called “plaque”. The formation of plaque and the breaking off of clots may be responsible for stroke, TIA or transient blindness (amaurosis fugax). Treatment of carotid stenosis by a qualified, experienced specialist can significantly reduce the occurrence of stroke, TIA or transient blindness.
Diagnosis:
Carotid Bruit are sounds heard over the neck. This may indicate the building of plaque in the carotid artery. Diagnosis of a carotid bruit is made by listening over the neck with a stethoscope. Carotid Duplex scan: This test is done by using an ultrasound machine to estimate the degree of stenosis. This is the first step in diagnosing carotid stenosis. Since the test is technician dependent it is important that an experienced lab or ICAVL accredited lab performs the test.
Dr. Mateo about to perform endovascular procedure.
Carotid Artery Stenosis - Treated without surgery by angioplasty & stent. This 76 year old man had an episode of slurred speech and weakness in his right hand
(Warning signs of stroke).
MRA:
This is non-invasive angiogram using MRI (Magnetic Resonance Imaging) a useful technique in confirming the degree of stenosis. Contrast angiogram: This is a diagnostic procedure in which a catheter is introduced in the artery through the groin. Dye is injected into the artery and X ray pictures are obtained to identify the position and degree of narrowing of the artery. This test is also done prior to treating carotid stenosis by balloon angioplasty and stent.
Treatment options:
Antiplatelet Medication: : Aspirin and Plavix reduces the binding of platelets (a component of blood). They have beneficial effects in preventing strokes in patients for whom surgery or angioplasty is not indicated. Carotid Endarterectomy:
A standard, durable, safe, and well-proven surgical procedure very effective in preventing stroke, TIA or transient blindness by removing plaque from the artery. The procedure is performed under general or regional anesthesia with minimal morbidity. Most patients go home the next day. Carotid Angioplasty & Stenting:
This is a new, minimally invasive procedure using balloon and stent to dilate the stenosis. We offer these alternatives to high-risk patients under protocol.
Our center is participating in a national study to evaluate the efficacy of carotid stenting compared to carotid endarterectomy.
Leaders in the treatment of Vascular Diseases
Vascular Associates of Westchester
(914) 593-1200 /(914) 593-1234
