An endovascular carotid stent is a mesh tube that is placed in a blood vessel in the neck. The stent will help to prop open the blood vessel and improve blood flow to the brain.
Plaque can build up on blood vessel walls. It can slow or block the flow of blood. The carotid artery supplies blood to the brain. Poor blood flow through the carotid can cause damage to the brain and lead to a stroke. The stent improves blood flow to the brain and lowers the risk of stroke.
Problems are rare, but all procedures have some risk. Your doctor will review some problems that may happen, such as:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of problems, such as:
Your doctor may do the following:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
The night before, eat a light meal. Do not eat or drink anything after midnight.
You will lie flat on a table. A roll will be placed under your shoulder. Your head will be turned to the side. A cut in the skin will be made along the side of the neck. The cut will run from just behind the ear to a point above the breastbone. Clamps will be placed above and below the plaque on the carotid artery. In some cases, a temporary bypass tube will be used to maintain blood flow around the area that is being operated on.
The artery will be opened and cleaned of plaque. The artery will then be sewn back together. The clamps and bypass tube, if used, will then be removed. A section of the carotid artery may need to be removed. In this case, an artificial graft or a segment of vein will be sewn in to replace it. The neck incision will be closed with stitches.
An arteriogram may be done to ensure that there are no complications, such as blood clots or narrowing. You may be given medication to help prevent blood clotting.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is 1-3 days. Your doctor may choose to keep you longer if complications occur.
It may take up to 2 weeks to recover. Slowly return to normal activity as tolerated. You may be referred to a dietitian who can help with dietary changes. These changes will help prevent a return of plaque build-up. Changes focus on a diet low in saturated fat. Make sure your diet is high in fruits, vegetables, grains, and fish.
Call your doctor if any of these occur:
If you think you have an emergency, call for emergency medical services right away.
American Heart Association
National Institute of Neurological Disorders and Stroke
Heart and Stroke Foundation of Canada
Brott TG, Halperin JL, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary. Stroke. 2011 Aug;42(8):e420-63 full-text, correction can be found in Stroke 2011 Aug;42(8):e541.
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Carotid stenting. UCSF Department of Surgery website. Available at: https://surgery.ucsf.edu/conditions--procedures/carotid-stenting.aspx. Accessed July 19, 2019.
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Last reviewed August 2019 by EBSCO Medical Review Board Rimas Lukas, MD Last Updated: 10/15/2019