Why is this procedure done?
The carotid arteries are major arteries in the neck that deliver oxygen-rich blood to the brain and head. Carotid artery disease occurs when fatty deposits (plaque) build up inside the carotid arteries and cause a narrowing or blockage, which can prevent blood flow to the brain.
Carotid artery disease can lead to a stroke, a medical emergency in which blood supply to the brain is reduced and brain cells may die. A stroke can cause permanent disability or death.
Carotid artery angioplasty and stenting are treatments used to open the blood vessels in the neck to improve blood flow to the brain.
How is the procedure done?
Carotid artery angioplasty and stenting are minimally invasive (nonsurgical) procedures performed in the hospital in the interventional radiology area. During the procedure, a catheter is inserted into an artery in the groin or wrist and threaded through the body to the site of the carotid artery disease (usually in the neck).
In an angioplasty procedure, a small balloon is threaded by a catheter to the area of the blockage. The balloon is then inflated for a couple of seconds to widen the artery, which improves blood flow through the neck and into the brain. The balloon is then removed from the patient.
In a stent procedure, a small metal tube is inserted into the artery to prevent the artery from narrowing again. The stent remains inside the artery.
What are my risks? What are common complications?
All medical procedures have risks. The risks of angioplasty and stenting can include bleeding at the site where the artery is entered, injury to the blood vessels in the neck and formation of blood clots inside of the blood vessels. As with any medical procedure, you should talk to your doctor about the risks versus the benefits of the procedure.
What do I need to know before the procedure?
This procedure is performed in the hospital and can take 1½ – 3 hours. Preparation generally begins a few days prior to the procedure date. Patients may be prescribed antiplatelet medications to start prior to the procedure, which will continue for a short time (typically at least six months) afterwards. You will have an overnight stay in the intensive care unit following your procedure.
You should not eat or drink anything after midnight on the night before your procedure. On the morning of your procedure, you should take all your morning medications with a small sip of water.
General discharge instructions.
- Keep the site clean and dry.
- You may have soreness, a bruise or a knot near where the needle was inserted for a few days to a few weeks. This is normal.
- Check the spot where the needle was put in for redness, pain, swelling and a lot of bleeding or drainage. Call us if this happens.
- You may shower the next day but do not soak the puncture site for two weeks (no tub bathing, swimming or getting in the hot tub).
- No exercising, lifting objects greater than 10 pounds or strenuous activity for the next five days.
- If you take Glucophage (metformin or metformin products), do not take it for two days after the angiogram. On the third day, start again as prescribed.
What should I expect while recovering?
Because this procedure is minimally invasive, recovery is typically quite rapid. Some patients will have neck pain for a few days following the procedure, but this discomfort doesn’t last long and often responds to over-the-counter pain medications. Most patients will go home the morning after the procedure is performed. We ask that you take it easy for five days to allow the artery access site to heal. That means no lifting heavy weights or vigorous physical exercise during the first five days. After that, you can return to normal activity. Some patients report feeling more tired than usual during the recovery period while the artery is healing, which can last a few months. Energy levels will typically wax and wane during this time period but will overall trend back toward normal.