Having Carotid Angioplasty and Stenting
Angioplasty and stenting is a type of
procedure to improve the blood flow in an artery or vein. The carotid arteries are large
arteries in your neck. During the procedure, healthcare providers use a thin tube with a
balloon at its tip to open up the artery. This is called angioplasty. A tiny mesh tube
called a stent is then put into the artery. It's left in place to help keep the artery
open. This is a minimally invasive procedure. It's done with a small cut (incision).
What to tell your healthcare
Before the procedure, make sure to
tell the medical team if you:
Have had any recent changes
in your health, such as a fever
Are pregnant or could be
Are allergic to shellfish or
Have ever had a bad reaction
to contrast dye
Have ever had a problem with
medicine that helps you relax (sedation)
Tests before your procedure
You may need some tests before the
procedure, such as:
Blood tests, to check for
anemia and infection
An electrocardiogram (ECG),
to check your heart rhythm
A chest X-ray, to look at
your heart and lungs
Ultrasound of your neck, to
look at the carotid artery
CT angiogram of the blood
vessels of your neck and head
Getting ready for your procedure
Talk with your healthcare provider
about how to get ready. Tell him or her about all the medicines you take. This includes
over-the-counter medicines such as aspirin. You may need to stop taking some medicines
ahead of time, such as blood thinners. If you smoke, you’ll need to stop before your
procedure. Talk with your healthcare provider if you need help to stop smoking.
Don't eat or drink after midnight
the night before your procedure. Your healthcare provider may give you more instructions
about how to get ready.
On the day of your procedure
Talk with your healthcare provider
about what to expect. The procedure will likely be done by a doctor trained in vascular
medicine and a team of specialized nurses. A typical procedure may go like this:
An IV (intravenous) tube will
be put in your arm or hand before the procedure starts. You’ll be given sedation
through the IV tube. This will make you relaxed and sleepy during procedure.
Hair in the area of your
procedure may be removed. The area may be numbed with a local anesthesia.
The doctor will make a small
incision in a blood vessel in your groin. He or she will then put a long, thin
wire into this cut. The wire acts as a guide during the procedure.
The doctor will then insert a
thin, flexible tube (catheter) over the wire. It has a tiny deflated balloon on
the end. The catheter will be threaded through the blood vessel all the way into
the carotid artery in your neck. Continuous X-ray images may be used to show
exactly where the catheter is.
The doctor will inflate the
balloon inside the narrow part of the carotid artery. This will stretch the area
A mesh tube called a stent
may be left in place in the area. This will help keep the area open.
The doctor will deflate the
balloon. He or she will remove the catheter.
The doctor will close and
bandage the incision site in the groin.
After your procedure
After the procedure, you will spend
several hours in a recovery room. You may be sleepy when you wake up. Your healthcare
team will watch your heart rate and breathing. You’ll be given pain medicine if you need
You may need to lie flat without
bending your legs for several hours after the procedure. This is to help prevent
bleeding from the incision site. You may be able to go home the same day. Or you may
need to stay in the hospital overnight. Your doctor will tell you what to expect. When
you’re ready to go home, you’ll need to have a family member or friend drive you.
Recovering at home
Your doctor may prescribe medicines
to help prevent blood clots or spasm of your blood vessels. Follow all of your
healthcare provider’s instructions. This includes any advice about medicines, exercise,
and wound care. You may have some pain after the procedure. You may have a bruise where
the catheter was inserted. You can take over-the-counter pain medicines if you need to.
Get some rest. Don't do any strenuous exercise for at least 24 hours.
If you had symptoms from your
carotid stenosis, these should go away after the procedure. In follow-up appointments,
your healthcare provider will talk with you about your continued care. This includes
ways to lower your risk for atherosclerosis. You also may need follow-up blood tests or
imaging of your neck.
When to call your healthcare provider
Call your healthcare provider right
away if you have any of these:
Fever of 100.4°F (38.0°C) or
higher, or as advised by your healthcare provider
Swelling or pain at the
incision site that gets worse
Fluid or blood leaking from
the incision site
Redness or warmth at the
Call if you have symptoms such
Sudden changes in speech or vision
Weakness on one side of the face or body
Sudden severe headache
Trouble standing or walking