A 30-year-old woman was successfully treated for arterial dissection with carotid stenting procedure. Arterial dissection is formation of tears in the innermost lining of the arterial wall.
The problem for Rupali Tyagi started after she suffered from severe pain in the back of her neck. As she didn't pay much heed to it, she started developing weakness in the right side of her body.
‘Timely diagnoses of arterial dissection can be cured with medications. Carotid stenting is done, when patients do not respond to these medications.’
Later she consulted doctors and was initially treated with medicines, but her condition worsened over time. Compelled to consult a better hospital, Tyagi was later admitted to Agrim Institute of Neurosciences at city-based Artemis Hospital, where a detailed investigation revealed arterial dissection.
Arterial dissection refers to the abnormal, and usually abrupt, formation of a tear along the inside wall of an artery.
As the tear becomes larger, it forms a small pouch called a 'false lumen'. The blood that accumulates inside this false lumen can generate blood clots or otherwise block blood flow, leading to a stroke.
Each year in India, between 12,000 and 15,000 people are affected by spontaneous dissection of the carotid arteries, which accounts for up to 50 percent of all strokes, specifically in young and middle-aged people.
Following the case, a team of doctors was constituted under the leadership of Vipul Gupta, who is Director of Neurointervention at Artemis. CT angiographic study was done for the brain blood vessels which showed one of the vessels on the left side had narrowed.
"As blood vessels get torn they become narrow and some clots may form and go into the brain. In this case, severe narrowing of the vessels was causing decreased flow in the brain and deteriorated her condition further and she became partially paralysed and had lost her ability to speak," said Gupta in a statement.
Thereafter, the surgery was performed and carotid stenting was done. Carotid angioplasty is a procedure that opens clogged arteries to prevent or treat strokes.
The carotid arteries are located on each side of the neck and are the main arteries supplying blood to the brain.
According to Gupta, the patient remained stable and her brain functions started to improve completely after the surgery. "She was able to walk, talk normally without any problems when she came for a follow up."
Talking about arterial dissection, Gupta said that with timely and accurate diagnoses, most patients can be managed by medications itself, however, a few patients who do not respond to medications need stenting to repair the blood vessel.
Treated appropriately, most patients can recover and lead a normal life, he said.