What is carotid artery stenting?

Carotid stenting is a procedure that reopens the blocked section of the carotid artery. A small mesh, metal tube called a stent is placed in the blocked section. It acts like scaffolding to prop open the section. It may prevent or slow future plaque buildup.

Why is the procedure considered minimally invasive?

Instead of surgery, the physician makes a small incision into an artery located in the groin, arm, or wrist through which tiny devices are inserted. The devices are guided to the blocked area of the carotid artery. The patient remains awake while the physician performs the intervention and monitors the function of the brain.

What takes place during this procedure?

A local anesthetic is administered at the site in the groin, arm, or wrist where the stent will be inserted into the body. An incision several millimeters (about an inch) long is made. A guide catheter—a tube with a guide wire—is inserted into an artery at the incision site (most commonly the femoral artery in the groin). Using x-ray equipment, the physician moves the catheter through blood vessels to the blocked section of the carotid artery.

Usually, before inserting the stent, the physician needs to enlarge the blocked section, in a procedure called angioplasty. During angioplasty a small, deflated balloon is delivered through a catheter to the blocked area. Once the balloon is positioned precisely, it is inflated. This pushes the plaque buildup against the artery wall, widening the artery and restoring blood flow. The balloon is then removed.

Next, the stent is delivered via a different catheter to the same area of the carotid artery. It is expanded until it is firmly in place. After the catheter is withdrawn and the incision is closed, the stent remains in place to help prevent future narrowing.

What is embolic protection?

During angioplasty and carotid stenting, there is a risk that a plaque particle will be dislodged. The loose piece of plaque, called an embolism, could block an artery in the brain, causing stroke or even death.

To improve safety, a small filter called an embolic protection device is often used before angioplasty and stenting. This collapsible umbrella-like filter is attached to a guide catheter and advanced beyond the narrowed section of the artery. The "umbrella" is then opened. It filters blood flowing through the artery, trapping particles before they can reach the brain. After the stent is in place, the filter is collapsed and removed.

What can I expect after I have been treated with a carotid stent?

Patients who receive a carotid stent usually are well enough to leave the hospital and go home within one to two days following the procedure. Before leaving the hospital, your doctor and nurse will probably discuss:

  • How to care for the wound where the incision was made
  • How to use home monitoring equipment to take your blood pressure twice a day for about a month
  • A prescription for anti-clotting medication
  • When you can resume normal activities
  • Instructions concerning diet, exercise, and other behaviors that affect carotid artery disease

What health effects should I monitor?

Carotid artery disease cannot be completely eliminated. However, you can control it and help prevent further blockage and stroke. Your doctor will help you monitor your condition over time. The doctor also will help you eliminate or control risk factors such as high blood pressure, high cholesterol levels, and high blood sugar levels.

If you experience any symptoms of carotid artery disease or of an impending stroke, call your doctor immediately.

Is there anything I need to adjust in my lifestyle?

Making positive lifestyle changes can significantly improve how well you control carotid artery disease. These measures include:

  • Don't smoke
  • Work with your doctor to lower your high blood pressure (hypertension)
  • Eat foods low in saturated fat and cholesterol
  • Lose excess pounds if you are overweight
  • Exercise regularly
  • Lower your blood sugar if it is high
  • If you have diabetes, see your doctor regularly and follow all instructions
  • Take medications, such as aspirin, recommended or prescribed by your doctor
  • Try to reduce stress in your life

It is important that this information is provided for INFORMATIONAL PURPOSES ONLY and must never be considered medical advice or diagnosis.

Always consult with your physician if you have any concerns regarding your medical situation.

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