Angioplasty (Balloon & Stent)

About the Procedure

Carotid Angioplasty is a non-surgical procedure to diagnose and/or widen the carotid arteries located on both sides of the neck when fatty deposits of plaque build up along the walls. The build up of plaque, called atherosclerosis, or hardening of the arteries, causes the arteries to narrow (stenosis) and increases the risk for stroke. This minimally-invasive procedure is an alternative to carotid endarterectory, an older surgical procedure, where plaque is scraped off the sides of arterial walls. Carotid angioplasty is performed on people who've already had or are at risk for a stroke, and people who have been diagnosed with a 50 - 70% blockage of the arteries.

The procedure takes approximately an hour and is often performed under local anesthesia by a vascular surgeon or neurosurgeon. The doctor makes a small incision in the groin, inserts a thin catheter, and follows the femoral artery to the area of blockage in the carotid artery. An angioplasty balloon is used to dilate the vessel and push the plaque against the walls. A wire mesh tube (stent) is inserted to hold the artery open and, if desired, the balloon is used again to improve stent attachment. The catheter is removed and the groin incision is stitched.

What to Know Before the Procedure

When performing a procedure within a major artery which is narrowed and lined with plaque, the risks can be serious. Complications are not common but patients are advised that the following may occur: blood clots, perforation of the arteries, infection, and plaque becoming dislodged and traveling to the brain causing a stroke either during or after the angioplasty.

For several days before the scheduled angioplasty the physician will prescribe an anticoagulant medication such as Heparin or Aspirin, intended to lessen the likelihood of a clot during or after the procedure. Preadmission x-rays and blood work will be done prior to the day of the procedure and pre-operative instructions on food and water intake will be provided by the doctor. Plan in advance for a ride at discharge as post-operative pain medications may cause drowsiness and the neck may ache.

What to Know After the Procedure

Following the procedure the patient is monitored in the recovery room to observe signs of complications. Discharge is usually the same day. During recuperation, the patient's neck may ache slightly. The doctor may recommend against turning the head often or too quickly. The patient may resume normal, non-strenuous activities in one or two days and return to work as comfort allows.

The physician will want to follow-up to discuss lifestyle changes such as diet, exercise, quitting smoking and reducing alcohol use to help avoid recurrence or progression of the underlying diseases which cause plaque build-up.

If you Need to Travel Outside of your Local Hospital

Finding a skilled physician with excellent credentials and experience is critical in avoiding serious complications and should be a determining factor in choosing where the angioplasty will be performed. Due to the risk of blood clots after the procedure be sure to speak with your doctor in detail about the best methods for avoiding complications and how they will affect long distance travel arrangements.