A carotid endarterectomy is a surgical procedure in which the carotid artery is exposed and plaque is removed, thereby reducing the risk of a thrombus breaking off and interrupting blood flow to the brain. Patients are often hospitalized for 48 hours after the procedure. Complication rates for carotid endarterectomy are approximately 3 percent.

A stent is a small, slotted, stainless steel tube is placed over an angioplasty balloon catheter and threaded up the artery to the area of the blockage. When the balloon is inflated, the stent expands, locks in place and forms a rigid support to hold the artery open. The stent remains in the artery permanently.

Carotid Stenting basically involves the same technique as for coronary angioplasty. Initially, we dilate the lesion with balloon angioplasty and then place a stent across the blockage. The whole procedure takes only half an hour to 45 minutes and the risks are considerably less than carotid surgery, even though carotid stenting is just evolving. Further refinement in equipment and technique greatly reduces the risks.

Blood flow to the brain is restored CEA has been the standard of care for the treatment of carotid stenosis for the last four decades.

However, now as we speak there is now a new treatment called stenting. As we use a stent in the arteries in the heart, we are now stenting the carotid arteries. We are one of the few centers where it is being done. And there are 70 centers in the country that are testing whether stenting is better than the operation. The operation has been highly successful and the risk of complications is only 1 to 3 per cent.

Currently, there are several groups of physicians in some form or another involved in endovascular procedures. Internal Medicine Physicians include: 1)Interventional Cardiologists 2) Vascular Medicine Specialists

Endovascular surgery may be considered a form of minimally invasive neurosurgery, because it requires only a small incision in the groin to gain access to a blood vessel, usually an artery located in the brain, head or spine. This removes the need to expose the brain or spinal cord by traditional surgical means. Because these procedures involve smaller incisions, less pain and shorter hospital stays, they reduce the amount of stress and risk of complication to the patient.

A stroke results from the interruption blood flow to the brain. The most common cause of this interruption is narrowing or blockage of the carotid artery. This blockage typically is due to accumulation of atherosclerotic plaque in the vessels. The two carotid arteries are the major suppler of blood to the brain and obstruction of this blood flow can lead t stroke. Blockage of the carotid arteries is the major cause of stroke in the United States.

Carotid artery disease occurs when plaque builds up on the artery wall. This condition is called stenosis and is the leading cause of thrombolotic stroke. Early warning signs of stenosis can be detected by a primary care physician during a regular physical exam and include the presence of a carotid bruit or a difference in blood pressure in the right and left arms.

The main supply of blood to the brain is carried by the carotid arteries. The carotid arteries branch off from the aorta (the largest artery in the body) a short distance from the heart, and extend upward through the neck carrying oxygen-rich blood to the brain. There are four carotid arteries: the right and left internal carotid arteries and the right and left external carotid arteries. One pair (external and internal) is located on each side of the neck.

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The key component that makes endovascular surgery attractive compared to conventional surgery is usually related to recovery time and patient risk. Endovascular options usually (but not always) have a lower risk than conventional surgical approaches, and usually have shorter recovery times for the patient. Unfortunately, endovascular procedures are often not nearly as durable (stay open or work) as many of the conventional surgical approaches.

Coronary Stenting involves the placement of one or more coronary stents as part of a special balloon angioplasty procedure. A coronary stent is a small, metal mesh tube that acts as a scaffold to provide support inside the coronary artery. A balloon catheter, placed over a guide wire, is used to insert the stent into the narrowed artery. Once in place, the balloon is inflated and the stent expands to the size of the artery and holds it open.

High Cholesterol can cause plaque formation in the carotid artery in the neck. As the plaque enlarges several adverse circumstances can be produced. Larger plaques become friable and can release particles that migrate to the brain. Once in the brain these particles can block small blood vessels causing a stroke. The enlarging plaque can also completely block the carotid artery depriving the brain of blood resulting in a stroke.

Actually this question is the most important to ask in our opinion. The first intervention into the peripheral vascular system can be the most important in that it can change a relatively innocent problem, or finding, into a limb or life threatening one down the road.

The carotid arteries are the major vessels that supply blood to the head, moving up both sides of the neck to the brain and face. When blood flow to the brain is blocked, a serious medical condition called a stroke or brain attack can occur. The narrowing or blockage is often caused by a buildup of blood clots and fatty plaques (like cholesterol) in the fork of the carotid artery where it branches into the vessels that supply blood to the face and brain.

Because the carotid arteries deliver blood to the brain, carotid artery disease can have serious implications by reducing the flow of oxygen and nutrients to the brain. The brain needs a constant supply of oxygen and nutrients in order to function. Even a brief interruption in blood supply can cause problems. Brain cells begin to die after just a few minutes without blood or oxygen.

Unlike a total artificial heart, the LVAS allows a patient's natural heart to remain in place, where it can help perform other critical biological functions. For example, the HeartMate blood pump works with the biological control mechanisms of the patient's natural heart to increase the heart's pumping capability when required, for activities such as climbing stairs.

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All martial arts have their specialties and unique character. Shotokan is traditional Japanese karate that specializes in punching, striking, kicking and blocking techniques. However, there is much overlap in technique among martial arts styles. For example, we also do sweeping, throwing and joint-locking techniques. In Shotokan, you won't see much of the flashy spinning and jumping about that is popular in martial arts movies - just techniques that are powerful and effective.