Procedure

Carotid Stenting- Cardiology, Neurology

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Carotid stenting is a type of surgery that expands the carotid artery to enhance blood flow in plaque areas. A slender and metal-mesh tube is inserted into the carotid artery.

The carotid artery plays an important role because it supplies blood into the brain. This artery is divided into two: the internal and external carotid arteries. Arteries that supply blood into the scalp and face are called external carotid arteries. The internal carotid artery is an important artery, as it supplies blood into your brain.

Atherosclerosis causes plaque buildup, which develops due to aging. If more plaques form, arteries become narrowed and thick. Cholesterol, calcium, and fibrous tissue make up the plaque. If this plaque will harden through time, blood clots may lodge in them and can block the brain’s arteries.

For this procedure, the doctor will embed a stent into your carotid artery after performing angioplasty, and uses a balloon that is inflated in the narrow part of the artery to open it. A balloon catheter may also be used by your surgeon to fully insert the stent. Carotid artery stenting is permanent. This type of surgery can be done within 1-2 hours.

Why is carotid stenting required?

Narrowing of the arteries in the brain can lead to sudden stroke in the coming years. This is why carotid stenting is done.

Which doctor to consult?

Talk to a cardiologist or a vascular surgeon, who will explain the procedure, the risks and after-care.

What to expect during carotid stenting treatment?

During carotid stenting, a wire is cautiously guided up to the carotid artery just beneath the narrowed area. Then, a specialized catheter will be placed through the wire over the area to inhibit blood clot formation and for splitting the walls of the arteries.

The stent and balloon are cautiously distributed into the narrowed area of the artery. A balloon is used to widen the artery. The stent will open and install into the arterial walls.

After the procedure, the balloon is then deflated and removed. The stent will remain in the artery permanently. To check if the narrowed area is widened successfully and if the stent is correctly positioned, a neck X-ray will be done.

Post-operative care

Bed rest for 1-2 hours is recommended after the successful surgery. Lifestyle changes are needed after the surgery, because some carotid arteries can still get narrowed down or thickened. These lifestyle changes include a healthy diet, regular exercise, maintenance of a normal body weight, stopping smoking and intake of maintenance medications.

Complications

Some medical conditions that increase the risk of complications after the surgery include:

  • Hypertension
  • Hypersensitivity to contrast dye
  • Twists or abnormal structures in the carotid arteries
  • Huge plaque or atherosclerosis of the aorta
  • Age over 80 years
  • Huge blockages in the arm and leg arteries
  • Poor kidney function

Talk to a cardiologist or a vascular surgeon, who will explain the procedure, the risks and after-care.

References 

  • Carotid Artery Stenting | Treatment for Carotid Artery Disease. (2019). Retrieved from http://www.circulationfoundation.org.uk/help-advice/carotid/carotid-artery-stenting
  • Department of Surgery - Carotid Stenting. (2019). Retrieved from https://surgery.ucsf.edu/conditions--procedures/carotid-stenting.aspx
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