Carotid angioplasty (kuh-ROT-id AN-jee-o-plas-tee) and stenting are procedures that open clogged arteries to restore blood flow to the brain. They're often performed to treat or prevent stroke.
The carotid arteries are located on each side of your neck. These are the main arteries supplying blood to your brain. They can be clogged with fatty deposits (plaque) that slow or block blood flow to the brain — a condition known as carotid artery disease — which can lead to a stroke.
The procedure involves temporarily inserting and inflating a tiny balloon into the clogged artery to widen the area so that blood can flow freely to your brain.
Carotid angioplasty is often combined with another procedure called stenting. Stenting involves placing a small metal coil (stent) in the clogged artery. The stent helps prop the artery open and decreases the chance of it narrowing again. Carotid angioplasty and stenting may be used when traditional carotid surgery (carotid endarterectomy) isn't possible, or it's too risky.
The carotid arteries are a pair of blood vessels located on both sides of your neck that deliver blood to your brain and head.
Carotid angioplasty and stenting may be appropriate stroke treatments or stroke-prevention options if:
In some cases, carotid endarterectomy may be a better choice than angioplasty and stenting to remove the buildup of fatty deposits (plaque) clogging the artery. You and your doctor will discuss which procedure is safest for you.
With any medical procedure, complications might happen. Here are some of the possible complications of carotid angioplasty and stenting:
Stroke or ministroke (transient ischemic attack, or TIA). During angioplasty, blood clots that may form on the catheters can break loose and travel to your brain. You'll receive blood thinners during the procedure to reduce this risk.
A stroke can also occur if plaque in your artery is dislodged when the catheters are being threaded through the blood vessels.
Before a scheduled angioplasty, your doctor reviews your medical history and performs a physical exam. You may also have one or more of the following examinations:
You'll receive instructions on what you can or can't eat or drink before angioplasty. Your preparation may be different if you're already staying at the hospital before your procedure.
The night before your procedure:
Carotid angioplasty is considered a nonsurgical procedure because it's less invasive than surgery. Your body isn't cut open except for a very small nick in a blood vessel in your groin.
General anesthesia isn't needed, so you're awake during the procedure. You'll receive fluids and medications through an IV catheter to help you relax.
Once you're sedated, your doctor makes a puncture in an artery, usually the femoral artery in the groin area. The following describes the angioplasty and stenting procedure.
When the procedure is done, you lie still in one position while pressure is applied to the site to stop bleeding. You generally won't have stitches, but a dressing is applied to cover the small incision site. You'll then be taken to the recovery area.
To avoid bleeding from the catheter insertion site, you need to lie relatively still for several hours. You'll be either in the recovery area or in your hospital room. After the procedure, you may receive an ultrasound of your carotid artery. Most people are discharged from the hospital within 24 hours after the procedure.
The catheter site may remain tender, swollen and bruised for a few days. There may be a small area of discoloration or a small lump in the area of the puncture. You may take acetaminophen (Tylenol, others) in the recommended dose as needed for discomfort, or other medication as prescribed by your doctor.
You may need to avoid strenuous activity and heavy lifting for 24 hours after the procedure.
In carotid angioplasty, a long, hollow tube (catheter) is threaded through the arteries to the narrowed carotid artery in the neck. A filter is inserted to catch any debris that may break off during the procedure. Then, a tiny balloon at the end of the catheter is inflated to open the narrowed area.
In carotid stenting, a long, hollow tube (catheter) is threaded through the arteries to the narrowed carotid artery in the neck. A metal mesh tube (stent) is inserted into the vessel to serve as a scaffold that helps prevent the artery from narrowing again. The catheter and the filter — which catches any debris that may break off during the procedure — are removed.
For most people, carotid angioplasty and stenting increase blood flow through the previously blocked artery and reduce the risk of stroke.
Seek emergency medical care if your signs and symptoms return, such as trouble walking or speaking, numbness on one side of your body, or other symptoms similar to those you had before your procedure.
Carotid angioplasty and stenting aren't appropriate for everyone. Your doctor can determine if the benefits outweigh the potential risks.
Because carotid angioplasty is newer than traditional carotid surgery, long-term results are still under investigation. Talk to your doctor about what results you might expect and what type of follow-up is needed after your procedure.
Lifestyle changes will help you maintain your good results: