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Carotid Stenting and Endarterectomy

Carotid artery stenting is an endovascular technique used to re-open blocked carotid arteries and prevent stroke. Because carotid stenting is minimally invasive, it provides an excellent treatment option for patients with carotid artery disease who are high-risk candidates for endarterectomy surgery.

X-ray studies using special dyes, called carotid angiograms, can show the degree of blockage of the carotid arteries. Other tests such as ultrasound and magnetic resonance angiography (MRA) can also visualize blockages in the carotid arteries.

Carotid artery stenting requires only a local anesthetic and a tiny puncture into an artery in the groin area, rather than opening the artery in the neck. The blockage is treated with balloon angioplasty and the placement of a stent – a small, self-expanding metal tube or 'scaffold' that keeps the vessel open, thereby preventing a stroke from occurring.

A tiny umbrella-like filter is used to catch and remove loose pieces of plaque that develop during the stenting procedure before they travel to the brain and create a stroke.

Carotid artery stenting is FDA-approved for preventing strokes in patients who are at high risk for carotid endarterectomy. Patients who receive a carotid stent usually leave the hospital one or two days after the procedure.

Carotid Endarterectomy

Carotid endarterectomy is a surgical procedure that is preformed to remove deposits of fat called plaque from the carotid arteries in the neck. These two main arteries, located on each side of the neck, deliver blood and oxygen to the brain. As people age, plaque builds up in the arteries causing a disease called atherosclerosis, or hardening of the arteries in which the arteries narrow and thicken reducing blood flow to the brain. When narrowing occurs in either one or both of the carotid arteries, this condition is called stenosis. During a carotid endarterectomy, a vascular surgeon removes the fatty deposits to correct the narrowing and to allow the blood and oxygen to flow freely to the brain.