If the idea of undergoing surgery to clear a blockage in your carotid artery is a bit intimidating, ask your doctor about another, less invasive option called carotid stenting. You may be a candidate for carotid stenting if your carotid artery is narrowed by more than 60 percent or if you have had a mini-stroke or stroke. Even if you do not have symptoms of a blocked carotid artery, you may qualify for the stent procedure if your carotid artery is blocked by more than 80 percent or if you are considered high risk for the surgical carotid endarterectomy procedure.
Carotid stenting usually is done in conjunction with a carotid angioplasty procedure. This involves inserting a catheter, or long hollow tube, in the groin artery and then guiding it to the narrowed area. A tiny balloon at the end of the catheter is inflated to push plaque that is causing the blockage against the artery wall to improve blood flow. During the procedure, a small filter called an embolic protection device is inserted to help catch clots that may break away from the plaque and potentially cause a stroke. After the artery is opened and the balloon catheter removed, another catheter is inserted that guides a small compressed stent (slender, metal mesh tube) to the targeted area of the carotid artery. Once the stent is in place, it is released and expanded to fit the artery where it acts as scaffolding to hold the artery open. The catheter and embolic protection device are then removed, while the stent remains in place. Because the stent is made of stainless steel or metal alloy, it will resist rust.
Inserting a carotid stent takes approximately one to two hours. The patient remains awake during the procedure and usually is discharged from the hospital the next day. Normal activities may be resumed gradually after returning home. Lifting more than five to 10 pounds generally is not recommended and pressure should be avoided at the incision site. Blood thinning medications may be prescribed, and periodic follow-up appointments are necessary to monitor the placement and function of the stent.
Carotid stenting offers several benefits over surgical repair for narrowing of the carotid artery, including:
- Local instead of general anesthesia.
- Shorter operation and recovery times.
- Smaller incision site.
- Less discomfort.
However, carotid stenting is not for everyone. The procedure may not be recommended for people with an irregular heart rhythm, certain medication allergies, total carotid artery blockage, bleeding in the brain within the last 24 months, or a life expectancy of less than two years.
Carotid stenting can help restore blood flow, but it cannot cure carotid artery disease. To help keep plaque from building up again, commit to eating healthier foods, not smoking, exercising regularly, losing weight if necessary, and following your doctor’s recommendations to control diabetes or heart disease.