The carotid artery is a major blood vessel that supplies blood to the brain. A blocked or narrowed carotid artert leads to less blood to the brain and increased risk for a stroke. In order to repair a blocked carotid artery, a procedure called carotid angioplasty, or carotid catheterization, may be done. This procedure involves inserting a long, thin tube, called a catheter, into the carotid artery. A small balloon and a mesh tube, called a stent, are inserted to help open the carotid artery and ensure it stays open. However, carotid catheterization may result in serious complications.
Bleeding
According to the Cleveland Clinic website, bleeding at the site of the catheter insertion is a possible risk. While bleeding is always a risk of surgery, in the case of carotid catheterization there is the risk that bleeding within the brain--intracranial hemorrhage--will occur. This in turn could result in the patient experiencing a stroke after the carotid catheterization procedure. A stroke may cause only minimal damage, but it may also be fatal. Brain damage is another potential result of bleeding within the brain--the amount of brain damage depends on how much bleeding and what parts of the brain are affected by the bleeding.
Stroke
Dr. James Greelish, Dr. Emile Mohler III and Dr. Ronald Fairman, writing in the medical reference "UpToDate," report that strokes, which are caused by blood clots forming within the brain's blood vessels and interrupting normal blood flow to the brain, are the most serious immediate complication of carotid catheterization and angioplasty. Several possible processes may be the cause of the strokes, including blood clots forming within the brain, bleeding within the brain and decreased blood flow to the brain.
Heart Attack
A myocardial infarction, or heart attack, is another potential complication of carotid catheterization. Drs. Greelish, Mohler and Fairman summarized the results of two large studies published in 2010: one study was published in the "New England Journal of Medicine" and included more than 2,500 patients; the other was published in the "Lancet" and included more than 1,700 patients. The authors of these studies found different rates of heart attacks were associated with carotid angioplasty, but the rates ranged from 1 percent to 4 percent. Heart attack is a life-threatening potential complication; the UpToDate authors indicate that it is one of the most serious complications that can occur as a result of carotid catheterization and angioplasty.
References
- "New England Journal of Medicine;" Stenting versus Endarterectomy for Treatment of Carotid-Artery Stenosis; T.G. Brott et. al.; May 2010
- "Lancet;" Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial; J. Ederle et. al.; March 2010
- "UpToDate"; Carotid artery stenting and its complications; J. Greelish et. al.; June 2010
- Cleveland Clinic: Carotid Angiography and Stenting
- Medline Plus: Angioplasty and Stent Placement--Carotid Artery
