Stenting to Minimize Recurrent Stroke

Stenosis means narrowing or contraction of an abnormal channel or hole. Case of stenosis in the carotid arteries (heart blood vessels) and intracranial blood vessels (in the brain) can lead to a stroke. In patients who show symptoms of stroke (symptomatic), the action taken to eliminate the so-called stenosis stenting. Carotid stenting is a non-surgical but invasive procedure that aims to dilate blood vessels carotid stenosis by using a device called a stent plus supporting equipment (balloons and protective mechanisms). Stenting can provide high gain if the degree of stenosis of more than 70% and also in some cases the degree of stenosis 50-69%. If the patient had no symptoms (asymptomatic), minimizing the risk of stroke and stenting can be performed in patients with a degree of stenosis of more than 60%

Indications and Contraindications

Carotid stenting in large enough quantities was first performed in 1994 by Dr. Jay Yadav did in patients after carotid endarterectomy (surgery lift blockage in the blood vessels) who experienced restenosis. Indications stenting is to address the magnitude of lesion stenosis of more than 70% (in the asymptomatic) or are still about 50-69% (in patients with symptomatic). The advantage much more when stenting is performed at the first large lesions (> 70%). Carotid stenting should not be performed when plaque is difficult to reach due to the blood vessels that are too complicated (winding serpentine) and occurs classification (liming) great arch vessels around the heart. If there is a thrombus (occlusion) is shaped like a pendulum on the side of the plaque, then stenting is not recommended. In addition, carotid stenting is also not allowed for patients who are resistant to antiplatelet drugs (anti-clotting), patients with kidney failure and end stage of being, as well as patients who have a history of stroke complete within three weeks.

Complications

Carotid stenting can lead to complications, including:

1. Stroke or death
2. Nerve palsy brain
3. Bruised groin area, around the entry of the tool used

Plaque in the carotid arteries and intracranial vessels accounted for about 20-30% of the stroke. In an effort to prevent recurrent ischemic stroke by removing plaque before, then carotid stenting is an acceptable way. Carotid artery stenting has several advantages in preventing recurrent ischemic stroke, for example, can be performed in high-risk patients, the rate of complications after the action is relatively small, post-stroke mortality and a low action, length of stay in hospital relatively short (4-5 days if not no complications) so that the total cost of patients are also more efficient and shorter recovery time.