Carotid Stenting

What is carotid stenting? How does it work?

The carotid artery is a large main artery that runs up either side of your neck, providing blood to your brain and head. Carotid stenting involves placing a stent (small metal coil) in the artery to prop it open and allow blood to flow through the vessel more easily. It is commonly combined with a treatment known as carotid angioplasty, in which a catheter with a balloon on its tip is gradually inflated in your artery to push it open.

What conditions does this treatment treat?

Carotid stenting is normally performed to treat stroke as a result of carotid artery stenosis. Carotid artery stenosis happens when arteries are narrowed due to a build-up of fatty deposits (atherosclerosis), leading to a reduced blood flow to the brain. Your likelihood of getting atherosclerosis increases with certain risk factors like smoking, high blood pressure, high cholesterol and diabetes.

Carotid artery stenosis can eventually lead to stroke, if not treated in time.

What is expected during the treatment?

Carotid stenting uses a stent to keep the artery open and try to prevent it from narrowing again. This stent will remain in place after the surgery. 

Only a small incision is made in the groin in order to insert the stent into your artery where the blockage is, which means there will be no surgical scar. During the surgery, X-ray fluoroscopy will be used to guide the stents towards the affected part of the artery. You will be under general anesthesia during the procedure. 

There is a shorter recovery time as compared to other surgery options like carotid endarterectomy. In a carotid endarterectomy, an interventional neurologist will directly remove plaque and damaged parts of the artery. 

This procedure can be performed as an outpatient procedure, meaning you can return home within the day of the surgery and return to daily activities within the next 48 hours. Thus, this procedure is extremely safe.

How will it improve your condition and affect your life? (e.g. change in QOL, change daily tasks, etc.)

Post-surgery, you will find that your symptoms of carotid stenosis (neck pain, headaches etc)  improve in 1-2 weeks. You will be asked not to engage in any strenuous activity for the first week or so, but everything should return to normal after that.

What are some possible side effects or risks?

In general, this procedure is a very safe one, although complications and side-effects are always a possibility. Some possible surgical risks include allergic reactions to the injected material, as well as damage to the blood vessel and minor bruising or heavy bleeding at the site of the catheter insertion.

If not taken care of properly post-surgery, the blockage could return to your artery.

What do I do after I get this treatment?

After the carotid stenting procedure has been completed, you will probably need to return for a couple of check-ups, but minimal follow-up medication will be required and you can more or less resume your daily activities. 

If you have any questions about this procedure, do seek clarification with your doctor and find out whether this treatment is suitable for you.