September 29, 2021

Carotid artery stenting is a procedure to improve the blood flow in the carotid artery blocked by a plaque. The interventional neuroradioloist does so by placing a stent in the blocked area that expands, removing the block, and establishing adequate blood flow.

The procedure is usually done to prevent or manage strokes.

Let’s understand more about the procedure!

What is carotid artery stenting?

Carotid artery stenting is used to treat or prevent stroke in the brain. With the help of this procedure, blocked or narrowed arteries of the brain are hidden. Best carotid artery stenting is provided by Dr. Akhil Monga in Mohali.

The Procedure

Atherosclerosis or hardening of the arteries can cause plaque formation on the blood vessel wall, narrowing them. Gradually, the stiff and narrow arteries are unable to maintain adequate blood flow through them. In some cases,  blood clots or pieces of plaque can break and block the arteries, preventing blood flow to a part of the brain.

The carotid stenting procedure involves the use of a stent in the carotid artery through angiography. During angiography, the surgeon introduces a catheter through a small hole in the femoral artery.

They will carefully move the catheter up to the carotid area where the block is present. The narrowing is crossed carefully and often a distal filter is placed to prevent any clot from going to the brain. The doctor will then inflate a balloon, expanding the artery. The interventional radiologist will now place a stent in the affected area to keep the artery open. The stent will permanently remain in the artery, preventing its narrowing.

It is a comparatively short procedure that takes about one or two hours in most cases.

After the procedure

You may be advised to lie down several hours after the procedure to avoid bleeding at the site of catheter insertion. In most cases, you may be discharged from the hospital within 24-48 hours. A repeat MRI might be done after the procedure. You will remain on blood thinners after the procedure to brevent blood clotting in the stent. The doctor may advise limiting physical activity and lifting heavyweight for a few hours after the procedure.

Benefits

Carotid artery stenting is an excellent procedure to prevent stroke if your carotid artery has >70% narrowing.

If you have had a stroke or transient ischemic attack (TIA), the procedure can help if the artery has more than 50% of narrowing or more. For optimal results, stenting should be done early after the stroke or transient ischemic attack (TIA) unless the stroke involves large part of the brain.

Risks

Some common side effects of the procedure may be:

  • Bleeding at the location of catheter insertion
  • Infection
  • Stroke
  • Injury to the blood vessels at the site of catheter insertion

Some factors that may increase the risk of side effects are:

  • High blood pressure
  • Allergy to the dye used during the procedure
  • Irregular heartbeat
  • Age above 70 years
  • Abnormal carotid arteries
  • Poor kidney function
  • Atherosclerosis of the aorta near the beginning of the carotid artery
  • Extensive blockage in the leg or/and arm arteries

While the incidence of these side effects is rare, the doctor will weigh the benefits and the risk before advising the procedure. They will recommend the procedure only when the benefits outweigh the risks.