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UAE: Doctors perform rare, first-in-Mena surgery on octogenarian to prevent brain stroke

The 90-minute procedure was completed by Dr Waleed Yasin Kadro, consultant interventional cardiologist at RAK Hospital

An 84-year-old patient with multiple health problems has received a potentially life-saving surgery.

Doctors saved him from a potential cardiac arrest and lethal brain stroke. They successfully performed the first carotid stenting through a radial artery access (wrist) in the Mena region.

The 90-minute procedure was completed by Dr Waleed Yasin Kadro, consultant interventional cardiologist at RAK Hospital. The patient had previously suffered a stroke and has a history of high blood pressure, borderline diabetes, and high cholesterol. He also had significant narrowing and blockage of his left carotid artery.

Carotid arteries are located on either side of the neck and are the main arteries supplying blood to the brain. These can become clogged with fatty deposits (plaque) that slow or block blood flow to the brain, potentially resulting in a stroke.

According to Dr Kadro, two months before this procedure was carried out, he also had placed a stent into this octogenarian patient’s blocked coronary artery (the artery that delivers blood to the heart).

At that time, ultrasound and other evaluation techniques had indicated that the patient’s left carotid artery was significantly narrowed due to plaque buildup, resulting in reduced blood flow to his brain and potential susceptibility to a new stroke.

The most common method of treating a blocked artery is a carotid surgery to remove plaque buildup. A surgeon makes a small incision in the neck and removes the plaque from the narrowed or blocked carotid artery in this procedure.

However, due to his advanced age and health complications, the carotid endarterectomy procedure was considered too high a risk. The only viable option was carotid artery stenting, Dr Kadro said.

Stenting involves placing a small metal coil (stent) in the clogged carotid artery. The stent helps keep the artery open and decreases the possibility of it narrowing or being blocked again by plaque buildup.

Explaining further, Dr Kadro said the carotid artery stenting procedure is usually carried out via the femoral artery located in one of the legs. However, due to his age and other prevailing medical conditions, as well as the presence of calcified lesions in his femoral arteries, the procedure could not be carried out via femur arteries.

“Due to the extreme limitations we faced in executing a standard procedure, we opted for unique carotid stenting through radial access, wherein we intervened from the radial artery on his right wrist, and through that entry, up the artery of his right arm, and on to the left carotid artery in his neck,” said Dr Kadro.

Dr Kadro said during the 90-minute procedure, a specialised filter to trap and remove plaque was inserted in the left carotid artery, along with a tiny balloon and a stainless steel stent. The patient was fully conscious, with his hands, feet and speech coherence being constantly monitored and evaluated by the RAK Hospital specialists’ team for signs of a mini-stroke.

Doctors say that this unique procedure was a risky one, especially due to the balloon’s inflation. The right medication kept the patient’s heart and blood pressure stable throughout the procedure, they added.

“An examination of the filter after its retrieval disclosed the presence of plaque which was prevented from reaching the patient’s brain. An angiogram conducted at the end of the unique procedure also confirmed no blockage of the left carotid artery distal branches,” said Dr. Kadro.

The patient, who hails from Syria has been living in the UAE for more than 42 years, could freely move around in RAK Hospital after this procedure before being discharged.

“We will continue to deliver our specialists’ unrivaled medical expertise and experience backed by the latest technology to patients in need of the most advanced medical treatment,” said Raza Siddiqui, CEO of Arabian Healthcare Group and Executive Director of RAK Hospital.

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