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 growing. The U.S. Food and Drug Administration (FDA)
has approved its use in the treatment of people who have severe carotid artery
narrowing and a high risk of complications from surgery. 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
new 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
seen with this procedure.
Carotid artery stenting may be as
effective as carotid endarterectomy in preventing stroke, heart attack, and
other complications in some people who have narrowed carotid arteries.1, 2, 3 Talk to
your doctor if you would like to know if carotid artery stenting is a good
option for you.
This procedure may prevent a
transient ischemic attack (TIA) and
stroke in some people who have had a TIA or stroke
linked with significant carotid hardening and narrowing (70% or more) and who
are not good candidates for carotid endarterectomy surgery.
Citations
Yadav JS, et al. (2004). Protected carotid-artery
stenting versus endarterectomy in high-risk patients. New England Journal of Medicine, 351(15): 1493-1501.
Mas J-L, et al. (2006). Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. New England Journal of Medicine, 355(16): 1660-1671.
Brahmanandam S, et al. (2008). Clinical results of
carotid artery stenting compared with carotid endarterectomy. Journal of Vascular Surgery, 47(2): 343-349.
Yadav JS, et al. (2004). Protected carotid-artery
stenting versus endarterectomy in high-risk patients. New England Journal of Medicine, 351(15): 1493-1501.
Mas J-L, et al. (2006). Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. New England Journal of Medicine, 355(16): 1660-1671.
Brahmanandam S, et al. (2008). Clinical results of
carotid artery stenting compared with carotid endarterectomy. Journal of Vascular Surgery, 47(2): 343-349.
