Carotid Angioplasty and Stenting

Carotid angioplasty is a surgical procedure to widen the narrowed carotid arteries, the main blood vessels that supply blood to the brain, to prevent stroke. Carotid angioplasty with stent placement is an alternative to open surgery for the treatment of carotid artery disease. Carotid artery disease is a condition where fatty material and plaque accumulates within the carotid arteries, causing a narrowing that hampers blood flow.

Carotid angioplasty is performed under local anaesthesia. Your surgeon will make a surgical incision over your groin and place a catheter (a flexible tube) into the femoral artery. The catheter is then gradually guided to the blockage in your carotid artery. A filter is then placed, beyond the site of narrowing, to entrap small fragments of plaque detached from the walls of the artery. A tiny balloon is guided to the area of the blockage and inflated to widen the artery and increase blood flow. Carotid angioplasty is often combined with the placement of a stent, a tiny mesh tube, inside the artery. The stent helps maintain the patency of the artery and prevents it from future narrowing.

Patients are usually discharged the next day of the procedure. Once at home, you can resume your normal daily activities.

Angioplasty and stenting may be an appropriate option for patients with:

• Asymptomatic (without symptoms) carotid artery disease with blockage of 80% or more
• Symptomatic (with symptoms) carotid artery disease with blockage of 50 % or more
• New narrowing or blockage, after carotid endarterectomy or angioplasty
• Severe heart or lung diseases
• Previous neck surgery
• History of radiation therapy for neck tumours
• Narrowing or blockage that is hard to approach with endarterectomy

Benefits

Some of the benefits of carotid angioplasty and stenting include:

• No need for general anaesthesia
• Minimal discomfort
• Enhanced approach to narrowed or blocked arteries
• Lower risk of infection, nerve damage and bruising
• Reduced hospital stays
• Quicker recovery
• Small skin incision

As with any surgery, complications may also occur with carotid angioplasty and stent placement. Some of the possible complications associated with carotid angioplasty and stenting include stroke or heart attack, bleeding at the catheter insertion site, blood clot formation, and repeated blockage of the carotid artery.

Before undergoing carotid angioplasty and stenting, your doctor will discuss the specific risks and potential benefits associated with the procedure, with you.