Carotid Angioplasty & Stenting

Outlook

Members of your care team will give you instructions about what to expect on the day of your carotid angioplasty and stenting procedure, including food and drink restrictions and guidance on any medications you should stop or start in advance of the procedure. Carotid angioplasty and stenting is performed in a hospital’s catheterization laboratory, or “cath lab.” You’ll be awake during the procedure, but you’ll be given local anesthesia to numb the catheter insertion site, and you’ll usually also be given medications to relax you.

During the procedure

A carotid angioplasty and stenting procedure involves the following process:

1. A thin, flexible tube (catheter) is inserted into an artery, usually near the groin, and threaded up to the carotid arteries in the neck where the blockage is. This is accomplished with the guidance of live X-ray imaging.
2. A small balloon is inflated to push the plaque to the sides of the artery wall and expand the artery.
3. When the balloon opens, plaque and other debris may break free. This debris is caught by a tiny umbrella-like device (called a distal protection device) to greatly reduce the risk of stroke during the procedure.
4. The interventional cardiologist will often place a stent to help keep the artery from renarrowing.
5. The procedure typically takes about two hours, though preparation time will add to that length. The interventional cardiologist may talk with you during the procedure to help monitor blood flow to the brain.

After the procedure

After a carotid angioplasty and stenting procedure, patients usually stay in the hospital for a day or two. This time in the hospital allows for recovery and lets the doctor monitor progress.

Patients are discharged with information about what activities they may need to limit and for how long. For example, you may be asked to limit lifting objects, driving, and avoiding all strenuous physical activity for 24 hours.

Your care team will notify you of warning signs that you should contact them, such as the following:

• Symptoms of a stroke such as confusion, difficulty speaking, or understanding speech or numbness or weakness of the face or limbs on one side of the body
• Fever
• Changes to the puncture wound in your leg, such as increased redness, drainage, or pain at the site when no pressure is applied
• Swelling in the leg in which the catheter was inserted

Long-term recovery

Your recovery from the carotid angioplasty and stenting procedure will typically be brief, but it’s only the beginning of preventing a future stroke, heart attack, or other cardiovascular diseases (CVD). Lifestyle changes and taking medications exactly as prescribed by your doctor can help slow, halt, or reverse the underlying disease process that caused blockages in your carotid arteries and affects all arteries throughout your body.