Carotid angioplasty with stent is a procedure to open or widen an artery in the neck (carotid artery) that has become narrowed. This is done by inflating a small balloon inside the artery and then placing a small piece of metal that looks like a coil or spring (stent) inside the artery. The stent helps keep the artery open by supporting the artery walls.

The carotid arteries supply blood to the brain. When fats, cholesterol, and other materials (plaque) build up in an artery, the artery becomes narrow and can become blocked. This can reduce or block blood flow to certain areas of the brain, which can cause serious health problems, including stroke.

Tell a health care provider about:

• Any allergies you have.

• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.

• Any problems you or family members have had with anesthetic medicines.

• Any blood disorders you have.

• Any surgeries you have had.

• Any medical conditions you have.

• Whether you are pregnant or may be pregnant.

What are the risks?

What happens before the procedure?

• Ask your health care provider about:

  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.

  • Whether aspirin is recommended before this procedure.

  • Taking over-the-counter medicines, vitamins, herbs, and supplements.

• Follow instructions from your health care provider about eating or drinking restrictions.

• Do not use any products that contain nicotine or tobacco for 4 weeks before the procedure. These products include cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.

• Ask your health care provider what steps will be taken to help prevent infection. These may include:

  • Removing hair at the surgery site.

  • Washing skin with a germ-killing soap.

  • Taking antibiotic medicine.

• You may have blood tests and imaging tests done.

• Plan to have someone take you home from the hospital or clinic.

• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• An IV will be inserted into one of your veins.

• You may be given one or more of the following:

  • A medicine to help you relax (sedative).

  • A medicine to numb the area where the catheter will be inserted (local anesthetic).

• Most commonly, an incision will be made in your groin. In some cases, an incision may be made in your wrist or forearm instead of your groin.

• A small, thin tube (catheter) will be inserted through your incision, into an artery. The catheter will be threaded upward into your carotid artery. An X-ray machine (fluoroscope) will help your health care provider guide the catheter to the correct place in your artery.

• Dye will be injected into the catheter and will travel to the narrow or blocked part of your carotid artery.

• X-ray images will be taken of how the dye flows through your artery. While the images are being taken, you may be given instructions about breathing, swallowing, moving, or talking.

• A filter (distal protection device) will be inserted into your artery. This will be used to catch plaque that comes loose in your artery during the procedure. This reduces the risk of plaque moving into your brain.

• A small balloon will be inserted into your artery. The balloon will be inflated for a few seconds to widen your artery and will then be removed.

• The stent will be placed in your artery.

• A second small balloon will be inserted into your artery and inflated. This expands the stent inside of your artery so that the stent holds up the artery walls. The balloon will then be removed.

• The catheter and the distal protection device will be removed from your artery.

• Your incision may be closed with stitches (sutures), skin glue, or adhesive tape.

• A bandage (dressing) will be placed over your incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.

• You may continue to receive fluids and medicines through an IV.

• You may need to have pressure placed on the incision site to prevent bleeding.

• You will need to keep the area still for a few hours, or as long as directed by your health care provider. If the procedure was done in the groin, you will be instructed not to bend or cross your legs.

• You may have some pain. Pain medicines will be available to help you.

• You may have a test that uses sound waves to take pictures (ultrasound) of the carotid artery. This can be compared to future tests to check for changes in the artery.

• Do not drive for 24 hours.

Summary

• Carotid angioplasty with stent is a procedure to open or widen an artery in the neck (carotid artery) that has become narrowed.

• The procedure is done to lower the risk of problems that can result from reduced blood flow to the brain, including a stroke.

• The stent placed inside the artery will help keep the artery open by supporting the artery walls.

• Follow instructions from your health care provider about taking medicines and about eating and drinking before the procedure.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.