Carotid Stent Procedure
Meet William, Tucson native
For patients who meet certain eligibility criteria, carotid angioplasty and stenting offers a less invasive approach than traditional surgical treatment for carotid stenosis. Carotid stenting can be performed while the patient is awake, reducing recovery time so patients like William, a Tucson native, can more quickly resume their active lifestyles.
The carotid arteries supply blood to a large portion of the brain. Carotid stenosis is defined as a narrowing of one of the carotid arteries in the neck and may be detected by physical examination and then confirmed using noninvasive imaging such as MR Angiography, CT Angiography, or Doppler Ultrasound.
Carotid angioplasty and stenting is a minimally invasive procedure that treats areas of significant narrowing in the carotid arteries. The procedure involves dilating (or widening) the narrowed area with a balloon. After the balloon is inflated, a stent (a mesh-like metallic device) is placed in the artery in order to keep the vessel open and maintain normal blood flow. The devices used for this procedure are not yet FDA-approved for this purpose, although this will likely change in the near future.
Carotid angioplasty and stenting is an alternative to a surgical procedure called a carotid endarterectomy. At this time, most patients who are reasonable surgical candidates should undergo a carotid endarterectomy rather than carotid angioplasty and stenting. However, angioplasty and stenting is a better alternative for patients who are not good surgical candidates, including patients with illnesses that prevent surgery, a history of prior radiation therapy to the neck, a history of prior carotid endarterectomy, and lesions that are difficult to access surgically.
Carotid stenosis may place a person at an increased risk of stroke and may also lead to mini-strokes (called transient ischemic attacks or TIA’s). Treatment with surgery or carotid angioplasty and stenting should be performed in many patients to reduce the chance of future stroke, though some areas of narrowing are best treated with medication. This decision should be made by a qualified medical professional.
Prior to your procedure, you will have a thorough consultation with our Neuroradiology Nurse Case Manager and one of our Interventional Neuroradiologists. All possible treatment options will be reviewed and discussed with you in detail, and all of your questions will be answered. If endovascular coiling is the treatment of choice for you, Radiology Ltd. will make the necessary arrangements for you.
After registering at the hospital, you will be sent to the Special Procedures Area, where you will have an intravenous (IV) line placed in your arm and a tube (Foley catheter) placed into your bladder. Fluids, pain medication, and blood thinners will be given prior to your procedure. You will then be sent to the Interventional Suite in the Department of Radiology, where you will meet with your doctor (Interventional Neuroradiologist) and the nurses and technologists trained in this procedure. You will be given sedation for relaxation and discomfort, but you will be conscious during the procedure.
A catheter (or plastic tube) will be advanced into the femoral artery located in your groin region and then advanced into the carotid artery. An angiogram will then be performed, in which images of the carotid artery are obtained during an injection of iodine-based contrast material. The area of narrowing will then be expanded with a balloon, and a stent will be placed into the artery to restore normal blood flow. A protection device may be used to prevent an unwanted clot from going to the brain. The catheter will then be removed. You will be observed in the hospital overnight. Most patients go home the next day and can return to normal activity within a couple of days.
Significant complications related to carotid angioplasty and stenting are uncommon. The primary risks associated with this procedure include:
- Groin hematoma or bruising
- Allergic reaction to the contrast material
For your safety and the protection of others, we do not allow anybody except patients in our exam rooms.
Your procedure will be performed by Dr. Ashdown, Dr. Gyorke, Dr. Jeck, or Dr. Rucker, all of whom are Senior Members of the American Society of Interventional and Therapeutic Neuroradiology (ASITN). They are trained in all aspects of neuroembolizations and are very experienced, with one of the most successful Interventional Neuroradiology practices in the country. For more information or clinical question, please call Faith Johnston at (520) 901-6616. To schedule a consultation, please call Tracey Bassett at (520) 873-3724.