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The blood vessels that bring blood to your brain and face are called the carotid arteries. You have a carotid artery on each side of your neck.
The blood flow in this artery can become partly or totally blocked by fatty material called plaque. A partial blockage is called carotid artery stenosis (narrowing). A blockage in your carotid artery can reduce the blood supply to your brain. A stroke can occur if your brain does not get enough blood.
Two procedures can be used to treat a carotid artery that is narrowed or blocked. These are:
Carotid angioplasty and stenting; CAS; Angioplasty - carotid artery
Carotid angioplasty and stenting (CAS) is done using a small surgical cut.
Carotid surgery (endarterectomy) is the first choice for treating narrowed or blocked arteries. This procedure is very safe.
Carotid angioplasty and stenting carries a higher risk of leading to a stroke. However, it can be used as an alternative in situations where carotid surgery is not a good option. These may include:
Risks of carotid angioplasty and stent placement are:
Your doctor will do a physical exam and perform several medical tests.
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
During the 2 weeks before your surgery:
Do NOT drink anything after midnight the night before your surgery, including water.
On the day of your surgery:
After surgery, your doctor may want you to stay in the hospital overnight so that nurses can watch you for any signs of bleeding, stroke, or poor blood flow to your brain. You may be able to go home the same day if your procedure is done early in the day and you are doing well. Your nurse will talk to you about how to care for yourself at home.
Carotid artery angioplasty may help lower your chance of having a stroke. But you will need to make lifestyle changes to help prevent plaque buildup, blood clots, and other problems in your carotid arteries over time. You may need to change your diet and start an exercise program if your doctor tells you exercise is safe for you.
Brott TG, Halperin JL, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease. J Am Coll Cardiol.2011;
International Carotid Stenting Study Investigators. Dobson EJ, Featherstone RL, Bonati LH, van der Worp HB, et al. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial. Lancet. 2010;375:985-997.
Eisenhauer AC, White CJ, Bhatt DL. Endovascular treatment of noncoronary obstructive vascular disease. In: Bonow Ro, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 63.
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.