Angioplasty and stent placement - carotid artery

Alternative Names: Carotid angioplasty and stenting; CAS; Angioplasty - carotid artery

You have an artery on each side of your neck called the carotid artery. This artery brings needed blood to your brain and face.

The blood flow in this artery can become partly or totally blocked by fatty material called plaque. A partial blockage is called carotid artery stenosis (narrowing). A blockage in your carotid artery can reduce the blood supply to your brain. A stroke can occur if your brain does not get enough blood.

There are two invasive ways to treat a carotid artery that is narrowed or blocked. One is surgery called endarterectomy. The other is a procedure called carotid angioplasty with stent placement.

Description of Procedure

Carotid angioplasty and stenting (CAS) is done through a much smaller incision, by pushing instruments into your arteries:

• Your surgeon will make a surgical cut in your groin after using some numbing medicine. you will also be given medicine to relax you.
• Your surgeon will insert a catheter (a flexible tube) through the cut into an artery. The doctor will carefully guide the catheter up to your neck to the blockage in your carotid artery.
• Your surgeon will use live x-ray pictures to see your artery. This kind of x-ray is called fluoroscopy.
• Next your surgeon will pass a guide wire through the catheter to the blockage. Another catheter with a very small balloon on the end will be pushed over the guide wire and into the blockage. Then the balloon will be blow up. The balloon presses against the inside wall of your artery. This opens the artery and restores proper blood flow to your brain.
• A stent (a wire mesh tube) may also be placed in the blocked area. The stent is inserted at the same time as the balloon catheter. It expands when the balloon is blown up. The stent is left in place to help keep the artery open. The surgeon then removes the balloon.

Risks of Angioplasty and stent placement - carotid artery

Risks of carotid angioplasty and stent placement are:

• Allergic reaction to dye 
• Blood clots or bleeding at the site of surgery
• Brain damage
• Clogging of the inside of the stent (in-stent restenosis)
• Heart attack
• Kidney failure (higher risk in people who already have kidney problems)
• More blockage of the carotid artery over time
• Seizures (this is rare)
• Stroke is more likely with carotid artery angioplasty than with carotid endarterectomy

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Review Date: 3/28/2012
Reviewed By: A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington (6/28/2011).

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