EARLY SURGERY FOR CAROTID ARTERY STENOSIS CAN PREVENT STROKE: DR. BEDI ON WORLD STROKE DAY

Every year, 29th October is observed as World Stroke Day to highlight the serious nature and high incidence of stroke, raise awareness about the prevention and treatment of the disease and to ensure better care and support for survivors of stroke. The Federation for World Stoke Day 2017 states, “One in 6 people get a stroke in their lifetime and one out of four survivors of stroke suffer another stroke. Treatments that can prevent a second stroke include medications to lower blood pressure and cholesterol, anticoagulants for atrial fibrillation, surgery or stenting for selected patients with severe carotid artery narrowing.”

On the eve of World Stroke Day, Dr Harinder Singh Bedi, Chairman Cardio-Vascular Sciences at Ludhiana Mediways Hospital stated, “The most common Cardiovascular diseases are Coronary Heart Disease (CHD) and Cerebro-vascular diseases (like stroke). All diseases of the heart & blood vessels along with vascular diseases of the brain constitute Cardiovascular diseases.” He added, “Stroke occurs when blood supply to a part of the brain gets interrupted or blocked and consequently, brain cells get damaged or die leading to paralysis of certain parts of the body. The interruption of blood supply to the brain may occur as a result of clogging or blockage of the internal carotid artery (an artery that supplies blood to the brain) leading to an ischemic stroke. Ischemic strokes account for 80% of all strokes. Bleeding from a ruptured blood vessel of the brain leads to the formation of a blood clot (that also cuts off the supply of blood to a part of the brain), thereby causing a hemorrhagic stroke.”

Dr. Bedi said, “After heart attack and cancer, Stroke is the leading cause of death in India. Far worse than the mortality rate of stroke is its morbidity as it leaves two out of three victims disabled for life. Most people tend to think that stoke can affect only the elderly, but the truth is that nearly one third of stroke patients are below 60 years of age. The modifiable risk factors for stroke are High blood pressure, cigarette-smoking, diabetes, high blood cholesterol, physical inactivity, obesity and the presence of heart disease.”

The CardioVascular Surgeon further informed, “A temporary interruption of blood supply to the brain can cause a Transient Ischemic Attack (TIA) or mini-stroke. The symptoms of a TIA last from a few seconds to 24 hours. A Transient Ischemic Attack does not cause permanent neurological damage on its own, but is a precursor to a major stroke. The timely treatment of a TIA can save people from a major attack of stroke. Dr Bedi stated, “Though the symptoms of a mini- stroke are subtle and temporary, it is important to pay due attention to these symptoms. People should not ignore symptoms like trouble in seeing through one or both the eyes; numbness or weakness in the arms, legs or the face especially on one side of the body; difficulty in walking; dizziness, loss of balance or coordination; difficulty in speaking or understanding; confusion and a severe headache with no known cause.

Dr. Bedi informed, “One of the most important causes of a stroke or mini stroke is blockage in the internal carotid artery (an artery that supplies blood to the brain). The blockage is caused by cholesterol plaque or atheroma. This disease is called extra-cranial carotid artery stenosis and its treatment is done through a delicate but very simple and effective procedure called carotid endarterectomy or by stenting of the blockage of the internal carotid artery. However, the results of surgery are far better than stenting.” He further stated, “About 80% strokes can be prevented and the morbidity and mortality associated with this killer disease can be greatly reduced by changes in lifestyle, control of risk factors and surgery where indicated.”

Dr Bedi, who has a wide experience in surgery of the carotid arteries especially in acute stroke, recently presented his experience at the International Asia Pacific Conference on Vascular Interventions and the Vascular Society of India, where it was much appreciated by a large International gathering of experts. He has developed some innovative techniques to make carotid surgery safer and more effective”.