Strokes: Carotid stenting ''better amd kinder'' technique

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New Delhi, Jan 18 (UNI) The newer and less invasive technique of Carotid Stenting to prevent brain attacks or strokes might be a ''newcomer'' in the field but doctors believe it will soon become the standard treatment for the ailment which is the third largest killer after cancer and heart attacks.

''Strokes are also the single largest cause of disability and an angioplasty procedure called carotid stenting will soon become the standard treatment even though it is the newcomer,'' said Dr Atul Mathur, Director of Cardiology at Escorts hospital.

The older technique, Endarterectomy or CE, is cruder, has side effects and not all patients are suitable candidates for this procedure, he told reporters today.

Strokes occur due to a blockage in the carotid arteries which travel up the neck to provide blood to the brain.

''The CE procedure requires the doctors to perform a surgery on the neck area to open up the blocked artery and remove the fatty deposit, while during carotid stenting, a balloontipped catheter is inserted through a small incision in the groin and slid up to the artery.

''When inflated, the balloon flattens plaque against the vessel's walls. A stent is then inserted to keep the artery open and an umbrella-like filter opened downstream from the blockage to catch the debris that breaks free from the lining,'' Dr Mathur elaborated.

It is an evolving process and the Escorts hospital has already treated over 300 patients using carotid stenting, he said.

Carotid stenting is also a gentler and kinder approach for patients with serious illnesses and many appreciate not having a scar on their necks, he added.

It can be performed by interventional cardiologists as the treatment is similar to angioplasty performed in the heart's arteries, Dr Mathur said, adding that the cardiologists just needed to enhance their knowledge and skills to carry out the procedure.

Clinical trials across the world have found the success rate of both the procedures nearly the same but the recent Sapphire trial found the stenting technique superior when the heart attack risk was factored in.

The Escorts institute also launched the Indian Council of Carotid Intervention today.

Dr Mathur, who is also the first Indian doctor to get a US patent on a medical device for carotid access, is the founder chairman of the council which will have 10 members.

Leading cardiologists, radiologists and neurologists will be part of the council which is envisaged as a formal body to govern the growth of the carotid stenting module in a supervised manner.

The main focus of the council will be on providing appropriate training to doctors to upgrade their skills, conducting research in collaboration with international organisations and exchange of academic activities at the global level.

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