Carotid Artery Stenting

Carotid artery stenting (CAS) is a procedure that can be used to open narrowed carotid arteries. It is also called carotid angioplasty and stenting.

There are two carotid arteries—one on each side of the neck—that supply blood to the brain. Fatty buildup (plaque) can narrow or block these arteries (stenosis). When one or both of your carotid arteries are narrowed, it can make it hard for blood to flow to the brain. Carotid artery stenting may improve blood flow to your brain and lower your risk of having a stroke.

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 large artery—most often the femoral artery in the groin—and threads it through other arteries to the carotid artery. The doctor will put dye into the catheter. The dye will make your carotid artery show up on X-ray images so that the doctor can find the blocked section of the 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.

Stenting should:

  • Open up the artery and press the plaque against the artery walls, improving blood flow.
  • Keep the artery open after the balloon is deflated and removed.
  • Seal any tears in the artery wall.
  • Prevent the artery wall from collapsing or closing off again (restenosis).
  • Prevent small pieces of plaque from breaking off, which might cause a stroke.

The procedure usually takes about 1 to 2 hours.

What To Expect After Treatment

After the procedure, you will be moved to a recovery room. Your heart rate, pulse, and blood pressure will be closely monitored. The place where the catheter was put in (catheter insertion site) will be checked for bleeding. You may have a large bandage or a compression device on your groin at the catheter insertion site to prevent bleeding. You will be told to keep your leg straight.

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. The area may feel sore and the bruise may get bigger for a few days after the procedure. You can do light activities around the house but nothing strenuous for 1 to 2 weeks.

You will take antiplatelet medicines to help prevent a stroke. You will still need to make lifestyle changes like eating healthy, being active, and not smoking. This will give you the best chance for a longer, healthier life.

Why It Is Done

Carotid artery stenting is done to lower your risk of stroke or transient ischemic attack (TIA).

Your doctor may suggest that you have carotid artery stenting if:1

  • You have had a mild stroke or one or more transient ischemic attacks (TIAs) in the past 6 months and your carotid artery is narrowed by 70% or more.
  • You have a low risk for having problems (complications) from the procedure.
  • You have a high risk of complications from carotid artery surgery (carotid endarterectomy).

How Well It Works

Carotid artery stenting may work as well as surgery to prevent stroke and other problems in some people who have narrowed carotid arteries.2, 3 Talk with your doctor about whether stenting is an option for you.