What is carotid stenting?
Carotid stenting is a procedure in which your vascular surgeon inserts an expandable metal coil called a stent inside your carotid artery at the location of the blockage. The stent expands inside your carotid artery to increase blood flow in areas blocked by plaque.
The carotid arteries, which are located on each side of your neck, supply vital blood to your brain. Carotid artery disease occurs when the carotid arteries narrow or become blocked, reducing blood flow to your brain.
If a clot or plaque blocks the flow of blood to your brain, it can cause:
- Ischemic stroke (when a blood vessels that supplies the brain becomes blocked or clogged and impairs blood flow)
- Arterial embolism (small piece of plaque or a blood clot that breaks away from its original site and blocks another artery)
- Transient ischemic attacks (brief interruption of blood flow to the brain that can cause signs of a stroke)
To treat these conditions, your physician may recommend carotid stenting. Carotid stenting can help to reduce your chance of stroke from a reduced supply of blood through the stented artery. Carotid stenting has been approved to treat patients who:
- Are too high risk for standard carotid endarterectomy
- Have a significantly narrowed carotid artery (typically by more than 70 percent)
- Have had symptoms of TIA or stroke
Why choose Ohio State for carotid stenting?
Our vascular physicians are experts at treating carotid disease with either surgery or stenting, and are best equipped to recommend the best treatment for each individual patient. Through our participation in ongoing research registries, we have access to all available carotid stenting equipment for all patients that would be best served with a carotid stent.
What to expect during carotid stenting
Preparing for your procedure
To prepare for carotid stenting, you should tell your physician about any medications you are currently taking, including aspirin or any other over-the-counter blood-thinning medications. You may also be asked to take aspirin and a prescription blood-thinning medication called clopidogrel in the few days before your procedure. You will be required to fast prior to your procedure.
During your procedure
You lie on a special X-ray bed in an angiography procedure room or a catheterization lab. You are connected to a monitor that shows your heart rate and blood pressure.
During the procedure, your surgeon may talk with you or instruct you to squeeze a small toy or ball so that he or she can monitor your brain function. A dye is injected into your arteries and X-rays are taken to locate the narrow areas in your arteries.
An angioplasty may be performed prior to inserting the stent. During angioplasty, your surgeon inserts a catheter (long, thin tube) with an attached balloon into a small incision or puncture over an artery in your arm or groin. The catheter is guided to the blockage site in your carotid artery.
A small balloon called an embolic protection device may be inserted to help prevent strokes by catching the clots or debris that may break away from the plaque during the procedure. The angioplasty balloon flattens the plaque and widens the space where the blood flows through. After the artery is open, the catheter is removed.
Using another catheter, a compressed stent is guided to the same area in your carotid artery and released. The stent expands to fit the artery.
The stent-carrying catheter and any embolic protection devices are then removed. Stents remain permanently in your carotid artery.
Carotid stenting usually takes one to two hours, but may take longer in some circumstances.
After your procedure
Immediately following the procedure, pressure is applied to the catheter insertion site in the groin or arm to allow it to close and prevent bleeding.
You may be instructed to:
- Not lift anything more than five to 10 pounds after you return home
- Not take a bath for a few days (showering only)
- Drink water to help flush the dye out of your system
- Take blood-thinning medications
- Schedule periodic follow-up examinations to monitor the function of your stent