Carotid artery blockage is a crucial health condition requiring prompt medical intervention, as it can lead to severe complications. Dr. Sumit Kapadia, a distinguished senior vascular surgeon, provides expert guidance on the implications, diagnosis, and treatment of carotid artery blockages, enabling a broader understanding of this medical condition. Dr. Kapadia stresses the importance of recognizing the signs early to facilitate prompt and effective treatment.

Carotid artery blockage is the result of plaque accumulation within the arterial walls, disrupting the blood supply to the brain. Dr. Kapadia pinpoints the following causes:

Unhealthy Lifestyle:
The pursuit of unhealthy habits such as smoking, lack of physical activity, and a poor diet can lead to the buildup of plaques.

High Blood Pressure:
Consistently high blood pressure can damage the arterial walls, rendering them susceptible to plaque buildup.

High Cholesterol:
Elevated levels of LDL or ‘bad cholesterol’ as well as elevated triglycerides contribute significantly to the formation of arterial plaques.

Diabetes:
This condition can damage blood vessels and is a significant contributor to the development of blockages.

Age:
The natural wear and tear due to ageing makes older individuals more susceptible to blockages.

Minor stroke:
Some patients may develop temporary weakness of paralysis of upper or lower limb. Some may notice speech problems or temporary reduced vision of one eye. These are called as transient ischemic attacks ( TIA) and often are the warning signs of an underlying carotid artery stenosis.

Asymptomatic
Few patients who undergo carotid artery doppler, as a part of workup for other purposes are detected to have carotid stenosis.

Major paralysis
If the stroke causes major paralysis of upper & lower limbs as well as speech problems within a short time, early intervention by angiography and thrombosis removal methods are now the treatment of choice and have good results if done within 4 hours of the onset of stroke.

Treating vascular malformations requires a tailored approach, balancing efficacy and patient safety. The classification of vascular malformations is pivotal to determining the apt treatment strategy.

Dr. Sumit Kapadia emphasises the necessity of a bespoke approach to treating carotid artery disease. The method of treatment largely hinges on the severity and symptoms associated with the blockage. Here is a more detailed explanation of the treatment options he proposes:

Lifestyle Modifications:
Adopting a balanced diet, regular exercise, and refraining from smoking are foundational in managing and halting the progression of the disease.

Medication:
Medicines to manage blood pressure, cholesterol levels, and prevent blood clot formation can aid in managing the condition and mitigating risks.

Surgery – Carotid Endarterectomy:
This procedure is particularly recommended for severe blockages, usually above 70%. Dr. Kapadia elaborates that Carotid Endarterectomy involves making an incision in the neck to access the affected artery, followed by the careful removal of the plaque, restoring normal blood flow. The artery is then sewn back together, often using a synthetic or vein patch and the incision is closed. It is a standard and effective procedure, but like all surgeries, it comes with certain risks, which are imperative to discuss with the surgeon beforehand.

Stenting:
A stent is sometimes inserted to keep the artery open, which is a less invasive alternative to surgery. The suitability of stenting is determined based on individual health conditions and the severity or location of the blockage. A vascular specialist who performs both surgery as well as angioplasty may be able to give a balanced opinion about which treatment is suitable according to patient condition.

Acute stroke interventions
If a patient develops acute massive stroke, an early intervention by angiography, followed by percutaneous thrombectomy using specialized devices like Penumbra, Solitaire can be performed along with installation of clot dissolving medicines ( Thrombolytics).

Treatment costs can vary depending on multiple factors like hospital choice, type of treatment, and additional medical services. Dr. Kapadia urges the prioritisation of quality healthcare services to ensure optimal outcomes. Comprehensive discussions with healthcare providers about treatment plans and costs are crucial for making informed decisions.

Understanding the cost of treatment is critical when considering options for managing carotid artery blockage. Dr Sumit Kapadia emphasises the need for clarity in treatment costs to make well-informed decisions.

What is a Carotid Endarterectomy?
Carotid endarterectomy is a surgical procedure aimed at removing plaque buildup inside the carotid artery in your neck. This procedure is critical for restoring normal blood flow to the brain and preventing severe complications, including stroke.

How is the Procedure Performed?
This surgery usually takes 1-2 hours and is performed under general anaesthesia. Dr. Kapadia explains the procedure as follows:

• An incision is made along the front of your neck.
• The carotid artery is opened, and the plaques causing the blockage are meticulously removed.
• The artery is then repaired using stitches or a patch made with a vein or artificial material (graft).
• Most patients can typically return to work 3 to 4 weeks after undergoing a carotid endarterectomy.

Cost Related to Carotid Endarterectomy in India
Here is the cost associated with various treatments related to carotid artery blockage in India.

Conclusion

Dr Sumit Kapadia, with his extensive knowledge and experience in vascular surgery, insists on early detection and the right treatment for managing carotid artery blockage effectively. Awareness, education, and a proactive approach to health can significantly lower the risks associated with this condition, contributing to enhanced life quality. Dr. Kapadia’s insightful guidance aims to empower individuals to make informed health decisions, leading to improved overall well-being.