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Carotid angioplasty and stenting in carotid artery stenosis: neuroscience nursing implications
1Ege University Izmir Ataturk School of Health, Izmir, Turkey. nazan.oran@ege.edu.tr
Insights
Carotid angioplasty and stenting (CAS) offers a less invasive option for managing carotid artery stenosis, reducing stroke risk. Effective nursing care, including patient education and procedural understanding, is crucial for successful outcomes.
Area of Science:
- Neurology
- Vascular Surgery
- Cardiology
Background:
- Atherosclerosis-induced internal carotid artery stenosis is a major cause of embolic stroke and cerebral ischemia.
- Endovascular techniques, including carotid angioplasty and stenting (CAS), are increasingly used for managing carotid stenosis, especially in high-risk surgical patients.
- Advancements in endovascular access and cerebral emboli protection devices have improved the safety and efficacy of CAS.
Purpose of the Study:
- To review the etiology of stroke related to carotid stenosis.
- To discuss current endovascular treatments for carotid stenosis, focusing on CAS.
- To highlight the essential nursing management before, during, and after CAS procedures.
Main Methods:
- Review of current literature on carotid artery stenosis, stroke etiology, and endovascular treatments.
- Description of the basic steps involved in carotid angioplasty and stenting (CAS).
- Discussion of nursing care strategies, including patient preparation and post-procedure management.
Main Results:
- CAS is an emerging intervention for high-grade carotid artery stenosis in high-risk surgical patients.
- Effective nursing care is vital for patients undergoing CAS, requiring understanding of the procedure and potential complications.
- Patient and family education regarding the procedure, its aims, and consequences is a key nursing responsibility.
Conclusions:
- CAS provides a valuable nonsurgical option for managing carotid artery stenosis.
- Comprehensive nursing care, encompassing pre-procedure education, intra-procedure support, and post-procedure monitoring, is essential for optimizing patient outcomes.
- Nurses play a critical role in ensuring patient safety and well-being throughout the CAS process.
Abstract:
Stenosis of the internal carotid artery due to atherosclerosis can cause embolic stroke or cerebral ischemia, both of which may result in significant morbidity, mortality, and long-term disability. Although the endovascular technique with balloons and stents to relieve arterial (i.e., coronary) stenosis has allowed a nonsurgical approach to the management of atherosclerotic disease for many years, its use in carotid vessels has only recently gained popularity. In addition, improvements in endovascular access systems have extended the use of carotid angioplasty and stenting (CAS), especially since the advent of cerebral emboli protection devices. Nowadays, CAS is emerging as an intervention for high-risk surgical patients with high-grade carotid artery stenosis. Nursing care of these patients before, during, and after CAS is challenging. Patients and family need to be educated about the aim and consequences of the procedure and its complications. To care for these patients, the nurse must understand the techniques of CAS. The purpose of this article was briefly to review the etiology of stroke, the current treatments to relieve carotid stenosis, and the basic steps of CAS. The nursing management throughout the procedure, the patient preparation before the procedure, and most importantly, the postprocedure nursing care are discussed.
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