Carotid Artery Angioplasty/Stenting
For more information, please visit our Cerebrovascular, Stroke and Endovascular Program site
What is it?
The carotid arteries are a pair of arteries that start from or near the aorta and travel in the neck towards the head, where they supply blood to a large portion of the brain. Over time, plaque can build up within one or both of the carotid arteries, leading to stenosis, or narrowing. These plaques can lead to stroke. Carotid stenting is a procedure designed to increase the size of a carotid artery that has been narrowed by plaque. It is usually offered to patients who are at a higher risk for Carotid Endarterectomy due to high medical/surgical risks, recurrent stenosis after prior endarterectomy, radiation induced carotid stenosis, occlusion of the carotid artery on the other side, or stenosis of the carotid artery that can’t be reached by open surgical methods, such as that near the base of the skull.
What is its goal?
The goal of carotid stenting is to reduce a patient’s risk of stroke.
How is it done?
Endovascular treatment involves inserting a hollow plastic tube (a catheter) into an artery and threading it through the body to the carotid artery. X-rays are used to help guide the catheter into position. A deflated balloon is then inserted through the catheter and guided into the carotid artery. The balloon is then inflated to help widen the artery; this procedure is called angioplasty. A stent (a slender metal tube) is then placed to help reduce the risk of the artery renarrowing.
What are the risks?
As with any disease of the brain or its blood vessels, the decision to undergo treatment for carotid stenosis requires a careful consideration of possible benefits versus risks. The risks of carotid stenting include bleeding or bruising, allergic reaction or kidney injury, and stroke. Additionally, a plaque requiring further treatment may return over time. There is no easy formula that can allow physicians and their patients to reach a decision on the best course of therapy—all therapeutic decisions must be made on a case-by-case basis.
What is the success rate?
In carotid stenting, success is measured by a decreased rate of stroke. In carefully selected patients, there is a significantly reduced stroke rate compared to those who do not undergo the procedure.
How long will I stay in the hospital?
Most patients are able to return home in one day following the procedure.
What is special about the way we deliver this treatment?
The University of Rochester Department of Neurosurgery includes surgeons specially trained to provide full care for all diseases involving the blood vessels of the brain. They are members of a multidisciplinary team that also includes Stroke Neurologists and Neuroradiologists. The team meets regularly to discuss all aspects of patients with complex problems.