Removing carotid block by stopping blood supplyMarch 25, 2020
Doctors at Aster Medcity gave a new lease of life to a 56-year-old woman patient by successfully removing blocks in her carotid artery, after completely the stopping blood supply to the brain.
The procedure was performed by a medical team headed by Dr Boby Varkey Maramattom, Interventional Neurologist and Dr George Varghese Kurien, Consultant, Cardiothoracic and Vascular Surgery. The blood supply to the brain was completely stopped for four minutes, according to the medical team.
Chandrika V P, a native of Edavanakkad in the district, was brought to Aster Medcity after suffering from a stroke. The blocks were formed due to the accumulation of fatty deposits or plaque, which in turn caused the stroke.
They were removed by performing a novel procedure, hybrid carotid revascularization with transient flow reversal. The blocks were removed by inserting a stent through a small incision made on the neck.
The stent was inserted directly into the patient’s blood vessels after cutting it and stopping blood supply using a clamp. Blood was allowed to flow outside the patient’s body while performing the procedure, which lasted four minutes. The blood supply was stopped in order to place the stent safely and avoid any kind of complications, including stroke, during the procedure.
“The plaques in carotid arteries are normally removed by inserting a stent through the femoral artery in the leg or opening up the carotid arteries. Both procedures involve certain complications,” said Dr Boby Varkey Maramattom.
When the stent is inserted through the femoral artery and pushed to the place of the block, the removed debris can get accumulated and block blood supply and cause stroke. If the neck is opened up, the vein passing through the area is likely to be damaged. It can also affect the patient’s voice. But the hybrid procedure helps to avoid bleeding and won’t affect cranial nerves leading to the tongue. Also, the procedure helps to flush out debris, he added.
According to Dr Maramattom the procedure was performed for the first time in India.
Dr. George Varghese Kurien said that in the instant case stenting was the only option due to various reasons. “It was not possible to perform open surgery in the patient because the bifurcation of the carotid artery was located near to the skull. Therefore, stenting was the only option. But in this case, placing stent through leg was also difficult. So, we decided to insert the stent by making a small incision on the neck. The recovery period of the procedure is also very less,” said Dr George Varghese Kurien.
The patient recovered a day after undergoing the procedure and discharged from the hospital on the third day. Dr Reji Paul, Senior Consultant, Neurology and Dr Jithendra T and Dr Nidhin Eldho, Anaesthesiology were also part of the medical team.