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First time in India a 93-Year-Old Patient Saved through Awake Carotid endarterectomy procedure

Chennai 3rd August 2022: A 93-year-old undergone a life-saving surgery after he was found to have multiple severe blocks in the arteries supplying blood to his brain and right carotid artery as it was 99% blocked. The patient was having frequent episodes of falls and giddiness and was suffering from hypertension and bronchial asthma for long years.

Carotid arteries are major blood vessels in the neck that supply blood to the brain, neck, and face. There is a pair of carotid arteries on both sides of the neck. Mr. Ibrahim (Name changed) had 99 percent block in the right carotid arteries and blocks in all the four blood vessels supplying blood to the brain. The blood flow to his brain was very minimal, causing dizziness and other problems. He was suffering from hypertension, dizziness and bronchial asthma for over years.

The brain needs a constant supply of oxygen and nutrients to work correctly. Even a brief break in blood supply can cause problems. Brain cells start to die after just a few minutes without blood or oxygen. If the narrowing of the carotid arteries becomes severe enough to block blood flow, or a piece of plaque breaks off and blocks blood flow to the brain, a stroke may happen.

The team of doctors performed CT angiogram which showed multi-vessel disease which is a high risk for stroke as blood supply to brain is reduced drastically. The team planned to reduce the risk of stroke and increase the blood supply by clearing the obstruction in the right carotid artery. A carotid endarterectomy was performed under regional anaesthesia to avoid general anaesthesia related complications. The patient was awake during the entire procedure which help in accessing the blood supply to brain by talking to the patient.

Dr.V.Balaji, Senior Vascular and endo vascular surgeon, Apollo Hospitals, said, “Blockage in the blood vessel going to the brain can be cleared to prevent stroke. This procedure is called carotid endarterectomy. Our department has performed more than 700 such procedures in the last twenty years very specifically under regional anaesthesia which reduces postoperative complications to minimum. Our post op success rates over the years have been more than 99% which exceeds any western institutions and the cost of the procedure is only one third when compared to western units.”

He also added, “This procedure is not for a person who has a massive stroke, but for a patient who has all the initial symptoms of transient Ischemic stroke this carotid endarterectomy will be helpful in preventing the stroke occurrence. A minimal of at least 2% of patient who come to our hospital falls in this category. Whereas most of the patient who visit the hospital land here with a full blown stroke attack. The transient ischemic attack (TIA) which is a minimal warning sign of a massive stroke should not be taken easy. Any person who notices the slightest symptoms of transient ischemic attack mimicking a stroke which includes numbness or muscle weakness, usually on one side of the body, Difficulty speaking or understanding speech, Dizziness or loss of balance, Double vision or difficulty seeing in one or both eyes, chocking should visit the hospital and get treated within 48 hours and carotid endarterectomy should be performed as there is a possibility of a massive stroke attack in six months which makes is difficult for the patient.”

Ms. Suneeta Reddy, MD, Apollo Hospitals Group, said, “Stroke affects approximately 1.8 million people a year in India and it is undoubtedly the most disabling disease in addition to causing death in some cases. Every 20 seconds, one Indian suffers a brain stroke, or three every minute, and the numbers are increasing alarmingly due to changing lifestyles. The most disheartening thig is 90 per cent of stroke patients failed to reach hospital on time. We need to create more awareness that treatment for brain strokes cannot start at home the patient should have medical attention within the golden hour.”

She added, “Apollo Hospitals is in the forefront in the adoption of digital technology and to use AI in a scalable manner for comprehensive stroke management. Apollo Hospitals’ comprehensive stroke center equipped with 24/7 emergency, a team of specialized experts, CT, MRI facility, and capability of specialized surgical and interventional therapies will have treatment taken to the next level through AI. With AI technology, stroke diagnosis has been standardized and scans will be available remotely within no time to the stroke physician. Acting fast when we see a stroke patient is the only awareness that is required.”

Patient made a quick and excellent recovery and its now five months post op doing well.

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