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Carotid Artery Stenting

Treatment Overview

Carotid artery stenting is a procedure to open a narrowed carotid artery. There is a carotid artery on each side of the neck. They supply blood to the brain.

Fatty buildup can narrow these arteries. This buildup is called plaque. When one or both of your carotid arteries are narrowed, it can make it hard for blood to flow to the brain. This buildup also raises your risk of stroke. This procedure may improve blood flow to your brain and lower your risk of having a stroke.

You will get medicine to prevent pain and help you relax. The doctor will put a small tube into a blood vessel in your groin or arm. This tube is called a catheter. The doctor will move it through the blood vessel to your carotid artery. Then the doctor will put dye into the catheter. The dye will make your carotid artery show up on X-ray pictures. This lets the doctor find the narrow section of the artery.

The catheter is used to move a balloon and an expandable tube, called a stent, into the artery. The balloon is placed inside the stent and inflated. This opens the stent and pushes it into place against the artery wall. The balloon is then deflated. The doctor will take out the balloon and catheter from your body. The stent will stay in your artery. After time, the cells lining the blood vessel will grow through and around the stent to help hold it in place.

The procedure usually takes about 1 to 2 hours. You may need to stay in the hospital for 1 or 2 days after the procedure.

How It Is Done

Carotid angioplasty procedure

During carotid artery stenting, a small, expandable tube called a stent is permanently inserted into the carotid artery.

To insert the stent, the doctor uses another tube called a catheter. The doctor inserts the catheter into a blood vessel in your groin or arm and moves it to the carotid artery.

A very thin guide wire is inside the catheter. The guide wire is used to move a balloon and the stent into the carotid artery. The balloon is placed inside the stent and inflated. This opens the stent and pushes it into place against the artery wall. The balloon is then deflated and removed, leaving the stent in place. After time, the cells lining the blood vessel will grow through and around the stent to help hold it in place.

What To Expect

You may need to stay in the hospital for 1 or 2 days after the procedure.

After you leave the hospital, you may notice a bruise or small lump where the catheter was put in. This is normal and will go away. The area may feel sore for a few days. You can do light activities around the house. But don't do anything strenuous until your doctor says it's okay. This may be for at least several days.

You will take medicines to help prevent a stroke. You will still need to have a heart-healthy lifestyle. This lifestyle includes eating healthy foods, being active, staying at a healthy weight, and not smoking. This will give you the best chance for a longer, healthier life.

You will have regular tests to check blood flow in your carotid arteries.

Why It Is Done

Carotid artery stenting is done to help lower your risk of stroke.

Your doctor may recommend this procedure based on certain things. These include:footnote 1, footnote 2, footnote 3

  • The amount of narrowing (stenosis) in your carotid arteries. A procedure may be an option if the narrowing is 50% or more.
  • Whether you had a stroke or TIA within the past 6 months. If you have not had a stroke or TIA, it is less clear that the procedure will help you.

Learn more

How Well It Works

If you have not had a TIA or stroke

For people who have not had a stroke or TIA, it is not clear when stenting might be a good choice. Stenting may help prevent a stroke in the long run. But in the short run, it increases the risk of stroke and death. Medicine and a heart-healthy lifestyle may work as well as stenting to prevent a stroke, and they don't have the risks of stenting.

Carotid artery stenting may be an option if you have more than 70% narrowing and you have a low risk of serious problems from stenting.footnote 1, footnote 3

It is not clear that stenting will reduce your stroke risk more than medicines and a heart-healthy lifestyle. Studies are being done to compare current medical therapy with stenting.

If you have had a TIA or stroke

Carotid artery stenting can help lower your risk of stroke if your carotid artery is narrowed by 50% or more. footnote 2, footnote 3

You may benefit most from stenting if it is done within 2 weeks of the stroke or TIA.footnote 2, footnote 3

Risks

The risks of carotid artery stenting include:

  • Infection.
  • Bleeding at the catheter insertion site.
  • Damage to the blood vessel at the catheter insertion site.
  • Stroke, heart attack, or death.
  • The artery can narrow again.

The risks of a procedure depend on things like your age and your overall health.

References

Citations

  1. Meschia JF, et al. (2014). Guidelines for the primary prevention of stroke: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, published online October 28, 2014. DOI: 10.1161/STR.0000000000000046. Accessed October 29, 2014.
  2. Kleindorfer DO, et al. (2021). 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline from the American Heart Association/American Stroke Association. Stroke, 52(7): e364–e467. DOI: 10.1161/STR.0000000000000375. Accessed June 4, 2021.
  3. AbuRahma AF, et al. (2021). Society for Vascular Surgery clinical practice guidelines for management of extracranial cerebrovascular disease. Journal of Vascular Surgery, published online June 19, 2021. DOI: 10.1016/j.jvs.2021.04.073. Accessed July 19, 2021.

Credits

Current as of: July 31, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Current as of: July 31, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Dear patient

I am excited to announce that I will be relocating my practice to Houston Methodist DeBakey Cardiology Associates. Starting November 4, 2024, my new address will be:

Houston Methodist DeBakey Cardiology Associates
6550 Fannin St.
Smith Tower, Suite 1901
Houston, TX 77030

Please note that my phone number and fax number will also change to the following:
24-Hour Telephone: 713-441-1100
Fax: 713-790-2643
Clinical Support Telephone (M-F, 8-5): 713-441-3515

I am excited about caring for you in my new office and hope you will make the transition with me. I will also continue to refill your medications as I have in the past. To assist, please provide your pharmacy with my new contact information.

Please consider checking your prescription refills to verify that you have enough medication on hand to last you until your next visit. Please note that your medical records will remain at my former office until you authorize their transfer. If you choose for me to continue providing your medical care, please complete and sign the enclosed “Authorization for Release of Medical Records” form and fax it to 713-790-2643. Once we receive your authorization, we will be happy to process the request for you.

Thank you for entrusting me with your medical care. My new team and I are dedicated to making this transition as seamless as possible. For help scheduling an appointment and transitioning your care, please call my new office number above.

I look forward to continuing your care at my new location.

Sincerely,
Gopi A. Shah, MD

Dear patient

Dr. Albert Raizner, Dr. Michael Raizner, and Dr. Mohamed El-Beheary are excited to announce that our practice, Houston Cardiovascular Associates, will merge with Houston Cardiovascular Associates on November 1, 2024.

Our new offices are similarly located in Houston, near the Texas Medical Center and in Sugar Land. Our in-hospital care will continue at Houston Methodist Hospital in the Texas Medical Center and Houston Methodist Sugar Land Hospital. Importantly, our new offices expand our services with state-of-the-art equipment and amenities. Our core values will always be, as they began over 40 years ago when Dr. Albert Raizner founded HCA:

Integrity – Compassion – Accountability

Our new address and contact information are:

Your medical records are confidential and remain available at our new locations. We consider it a privilege to serve as your cardiologists and look forward to your continuing with us. However, should you desire to transfer to another physician, you may request a copy of your records by contacting us at our new addresses and phone numbers listed above.

We thank you for your trust and loyalty. As always, we will continue to be here to take care of you. Please do not hesitate to contact us if you have any questions or concerns.

Sincerely,

Dr. Albert Raizner,
Dr. Michael Raizner,
Dr. Mohamed El-Beheary