Carotid artery stenting is a procedure that can be used to open
narrowed
carotid arteries. This procedure is much like coronary
angioplasty, which is commonly used to open blocked arteries in the heart. Its
use in carotid arteries is relatively new but growing. The U.S. Food and Drug
Administration (FDA) has approved its use in the treatment of people with severe
carotid artery narrowing. It is performed at large, specialized medical
centers.
During this procedure, a tube (catheter) is inserted through a large
artery—most often the femoral artery in the groin—and threaded through other
arteries to the carotid artery. After the catheter reaches the narrowed portion
of the carotid artery, a small balloon at the end of the tube is inflated for a
short period of time.
The pressure from the inflated balloon presses the
plaque against the wall of the artery to improve blood
flow. A
stent (a metal tube) is placed in the artery to keep
the plaque from tearing open and to keep the artery from closing. New
crush-resistant stents with filters to catch clots have been developed. These
stents have solved problems seen with earlier stents.
The procedure takes about 1 hour. The person usually is awake during
the procedure and feels little pain. Usually, hospitalization is needed for
about 24 hours after the procedure to watch for complications. So far, few
problems have been encountered with this procedure.
Early studies show that carotid artery stenting holds promise and may
be as effective as surgery (carotid endarterectomy) in people who are at high
risk for stroke. Further large-scale studies are being conducted to clarify
when carotid stenting can be safely used.1
This surgery may prevent a
transient ischemic attack (TIA) and
stroke in some people who have had a TIA or stroke
caused by significant carotid hardening and narrowing (70% or more) and who are
not good candidates for carotid endarterectomy surgery.
Yadav JS, et al. (2004). Protected carotid-artery
stenting versus endarterectomy in high-risk patients. New
England Journal of Medicine, 352(15): 1493–1501.
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