A carotid endarterectomy is the main treatment for narrowing of the carotid arteries because it is very effective. However, there is also an alternative procedure called carotid artery stent placement, or "stenting".
Carotid artery stent placement
Carotid artery stent placement is less invasive than a carotid endarterectomy because it does not involve an incision being made in the neck.
Stenting is carried out under local anaesthetic and involves a narrow, flexible tube called a catheter being inserted into the femoral artery in your groin. It is then threaded up into the carotid artery using X-ray technology to guide it into place.
At the end of the catheter there is a small balloon which is inflated to around 5mm at the site of the narrowed artery. A small mesh cylinder called a stent will then be inserted into the artery. The balloon will be deflated and removed, leaving the stent in place to keep the artery open and allow blood to flow through it.
After the procedure, you will need to lie flat and keep still for about an hour to prevent any bleeding from the artery. You will also need to stay in hospital overnight and will be able to return home the next day.
Like carotid endarterectomy, there are some risks associated with stenting. The risk of having another stroke (6%) or dying (1%) are the same for both procedures. As with carotid endarterectomy, stenting will therefore only be recommended if you have severe stenosis.
The National Institute for Health and Clinical Excellence (NICE) has confirmed that stenting is a safe procedure and has good short-term results, although the long-term effectiveness of stenting is not yet known. However, NICE has advised that provided the procedural risks after stenting are judged similar to those after surgery, it is safe to offer this alternative.
