Carotid Artery Stenting

This is a surgical procedure, which is done to remove a dangerous area of narrowing (atheroma/ plaque) in the Internal Carotid Artery (ICA).This is done in order to reduce the risk of a further stroke or Transient Ischemic Attack (TIA) similar or more severe to one already had. It can be performed under local anaesthesia (you are awake) or general anaesthetic (you are asleep). The procedure is done by making a cut starting at the bottom of the neck just above your collar bone, going obliquely upwards and backwards in the direction of the ear lobe. After cleaning the artery of the plaque, it is closed. Most often with a patch to widen the vessel.

This is an operation, which aims to improve the blood flow to the brain through the internal carotid artery in order to prevent stroke or transient ischemic attack (TIA). The procedure consists of removal of atheromatous plaque, which is causing a narrowing the internal carotid artery. It can be performed under local anaesthesia (you are awake) or general one (you are asleep). Local anesthesia is preferable, because during the procedure you are asked to talk to us or squeeze a ball in order to monitor your brain perfusion. The procedure is done by making a cut starting at the bottom of the neck just above your collar bone, going obliquely upwards and backwards in the direction of the ear lobe. After cleaning the artery from the plaque it is closed, most often with a patch to keep the vessel widely patent.

Mr Usman Jaffer explains that abdominal aortic aneurysms (AAA) can be caused by a number of different factors. One of these factors is having a family history of aneurysms, so there is a hereditary component. But there are other causes such as atherosclerosis (hardening and narrowing of the arteries) which can happen as part of ageing and having other risk factors such as high blood pressure or smoking.

Mr Usman Jaffer explains some of the factors that may be important to consider when deciding which operation to have for abdominal aortic aneurysm (AAA). Research from our institution shows that there are a number of factors identified by key stakeholders (patients, surgeons, radiologists, anaesthetists, intensive care doctors, peri-operative doctors) that can allow you to make a more informed decision with your doctors. These include: pre-existing medical conditions, post-operative complications, 30-day mortality, type of anaesthesia, long-term durability of operation, time to return to normal activities, post-operative pain, patient expectations, impact on carers, personalised information, professional advice, involving others (family/friends), uncertainty, how invasive the surgery is, patient journey, patient values, social factors, need for follow up, length of hospital stay, probability of intensive care admission, impact of energy levels.

A non-invasive method to image the heart and the coronary vessels (the blood supply to the heart). The test will detect any narrowings, blockages or any other abnormalities in the blood supply to the heart which cause the symptoms that you experience.

The procedure is minimal invasive and can be done purely with needle access through the skin or with small groin cuts to access the Femoral arteries. The aneurysm is repaired by inserting a device on the inside of the arteries to exclude the aneurysm from the circulation. It can be performed either in the operating room or a dedicated interventional angiography suite. The device is inserted in two pieces: the main body from one groin artery and the separate leg from the other groin. A quality control X ray die test is performed to ensure a good seal at the end. Sometimes additional procedures might be necessary, such as: - internal iliac embolization (occlusion) if the distal landing zone is in the external iliac artery, - conduit (additional tube-graft stitched to the native artery) if access vessels are too small, - aorto-uni-iliac stent (stent with only one limb) if the other side is not accessible (example: occluded access vessel) and occlusion of the iliac vessels (iliac arteries originate from aorta within the lower abdomen) and to preserve blood flow to the lower limb femoro-femoral crossover graft is needed. Patients who are treated with EVAR need life-long surveillance for possible graft related complications which may need further procedures to fix them.