Carotid Artery Stenting

Narrowing of the carotid arteries, which take blood to the brain, with atheromatous plaque is a potential cause of stroke (about 15% of all strokes are caused by carotid disease), usually when some material from the plaque dislodges and travels into smaller vessels in the brain, causing a blockage. Typically carotid narrowing develops slowly over years, and the risk of stroke remains low until the narrowing becomes very severe (usually more than 70%).

The mainstay of treatment is management of the factors that contribute to the narrowing, with emphasis on a healthy lifestyle, including stopping smoking, and treatment of such things as diabetes, high blood pressure and raised cholesterol levels in the blood.

When the narrowing is very severe, however, some form of intervention may be advised in addition to treatment of the underlying factors, especially if the patient has already had a small stroke. One option is a surgical operation to remove the plaque, known as endarterectomy, but carotid stenting can also be done in most people. This is less invasive, usually done under local anaesthetic via a tube (catheter) inserted at the groin or the wrist, allowing a quicker recovery. With stenting, the plaque is not removed, but rather is pushed aside by the stent (a sort of mesh tube), helping to increase the area for blood flow to the brain and preventing dislodgement of the plaque.