What to Expect from Carotid Stenting

Over time, arteries may close due to the buildup of a fatty substance called plaque, that collects on the artery walls. When this happens in one of the carotid arteries that run under both sides of the jaw line, and carry blood to the brain, the condition is called carotid stenosis, and the insertion of a stent may be required to hold the artery open. Carotid stenting is the process of opening a clogged carotid artery through angioplasty. Much less invasive than surgery, this common procedure is used to open any artery throughout the body that may be blocked and impeding the flow of blood.

This buildup of plaque is normally the result of several factors, such as genetics, smoking, and eating foods that are high in cholesterol. Once the condition is diagnosed, through blood workup, ultrasound, or another method, the treatment can be determined. This may be simply monitoring the artery annually for further closure, and prescribing blood thinners, and a low cholesterol diet, or it may mean surgery or angioplasty.

Surgery for a blocked carotid artery is called  an endarterectomy, and it is more invasive than angioplasty. The patient is put under a general anesthesia, and an incision is made in the neck to reach the artery. The plaque in the artery is then cleaned out, restoring the flow of blood. In carotid angioplasty and stenting, the patient is given a local anesthetic and medication for relaxation. A small incision is made in the groin area, and a tube is inserted that goes up through the body into the artery. All this is done through an imaging system that allows the patient to watch the progress. Once the artery is reached, a balloon is expanded in the artery to enlarge it, and the stent is put into place. The stent, a small wire mesh cylinder, holds the artery open when the balloon is removed. The stent will then continue to hold the artery open and blood flow is restored.

Recovery time from an endarterectomy is a little longer than for an angioplasty and stent placement, due to the size of the incision. In the case of stent placement, the patient is required to rest for a few days, however, for the most part, the only discomfort may be minor pain from the small incision in the groin.

Monitoring will continue after either of these procedures, and the patient will most likely be required to take a blood thinning medication, a drug to help lower cholesterol, and sometimes, a daily low dose aspirin. They will also be told to exercise regularly and limit their intake of high cholesterol foods.