Carotid Angioplasty and Stenting

Overview

Carotid angioplasty and stenting, an alternative to open surgery, is a treatment for carotid artery disease. Angioplasty widens narrowed carotid (neck) arteries and reduces the risk of stroke. Carotid artery disease occurs when carotid arteries become clogged with waxy plaque buildup (atherosclerosis). The narrowed arteries interrupt blood flow to the brain.

You'll receive local anesthesia during the angioplasty. The surgeon begins by making a small puncture in the groin artery, then inserts a long, hollow tube (catheter) into the artery, moving it to the narrowed area. The surgeon places a tiny filter past the narrowing to trap bits of plaque that may detach from the artery walls. A small balloon that inflates at the tip of the catheter opens the artery, and the surgeon places a small metal tube (stent) to keep the artery from narrowing again. People usually leave the hospital the next day and can resume normal activities at home soon after.

Carotid angioplasty and stenting may be appropriate if you have:

• A new blockage after having an endarterectomy or angioplasty (restenosis)
• Artery blockage of 50 percent or more and a history of stroke, ministroke (transient ischemic attack) or loss of vision in one eye (amaurosis fugax)
• Artery blockage of 80 percent or more and no symptoms
• Conditions such as severe heart or lung disease, prior neck operations, neck tumor radiation or kidney failure
• Narrowing of arteries that is difficult to access with surgery

All procedures carry some risk. Your doctor will discuss the risks and benefits of carotid angioplasty and stenting before you decide whether to have the procedure. Advantages of carotid angioplasty and stenting include:

• Better access to narrowed arteries
• Less discomfort
• No general anesthesia needed
• Reduced risk of wound complications, nerve injury and bruising
• A shorter hospital stay and recovery time
• A smaller incision

Mayo Clinic vascular surgeons, neurosurgeons and cardiologists have experience performing carotid angioplasty and stenting to treat carotid artery disease.