3rd December 2018: Timely diagnosis & a successful intervention by the Cardiac team at Narayana Multispeciality Hospital, Jaipur helped avert a life-threatening situation in a 79-year-old patient hailing from Gangapur city. The patient suffered from carotid artery stenosis - blockage in the arteries that supplies oxygenated blood to the brain.
"When the patient came to the hospital, he was partially bedridden. In the last 2-3 months, he had suffered recurrent episodes of falling down/fainting & injuring himself, every time he attempted to walk a few meters. When we took the patient's history, we found out that the patient had suffered a right-sided paralysis attack three years ago from which he had now recovered. These symptoms made us suspect that the brain was not receiving enough blood which was confirmed via diagnostic tests" said Dr. Anshul Patodia, Consultant - Cardiology at Narayana Multispeciality Hospital, Jaipur.
DSA (Angiography) Test results revealed 100% blockage in the left carotid artery & 95% blockage in the right carotid artery. The blood flow to the brain was severely compromised & any further blockage would lead to immediate death. This made prompt treatment necessary.
This case was extremely risky as previously the brain was surviving on minimal blood, it received from the right artery only. Opening of the blocked artery would lead to sudden rush of blood to the brain. If not managed well, this could cause enormous spike in blood pressure potentially leading to severe brain swelling, bleeding or even death. Also, while performing the procedure, if there was even a minor disruption in the blood flow to the brain - it could lead to on-table death. After evaluating all treatment options, right carotid artery stenting was found to be the most feasible & practical as the patient had multiple co-morbidities too. Despite it being an extremely risky case, where even a slight error could prove fatal, we took up the challenge & were successful added Dr. Patodia.
The patient was taken to the hospital's cath lab & carotid artery stenting was swiftly & successfully performed. Through a small nick in the groin, a catheter helped deliver a metal stent with inflatable balloon which opened the blockage. Special measures were undertaken, including inserting special filters to avoid any dislodged blood clot from blocking blood flow to the brain and having interventional neurologist Dr. Prashant Singh throughout to ensure prompt action in case of any neuro-emergency.
The patient recovered well & he could walk again without any difficulty, within 24 hours. "It has been seen that patients who have high risk factors or who have to undergo a complex surgery or intervention do best at specialized centers where the clinical & support team has a lot of experience. We are happy that the team could successfully perform the intervention and save the patient" said Dr. Mala Airun, Zonal Clinical Director, Narayana Multispeciality Hospital, Jaipur.