Carotid stent surgery is one of two procedures that can be used to treat carotid artery stenosis. This procedure is considered a less invasive option with a faster recovery time. However, it does have risks.

Carotid stent surgery is a minimally invasive procedure used to treat carotid artery stenosis, a condition that’s characterized by plaque buildup in the carotid arteries. The carotid arteries are major blood vessels located on either side of your neck that supply blood to your brain.

During carotid stent surgery, a stent (metal tube) is placed inside the carotid artery to keep it open so that blood can flow more easily without any obstruction.

Although carotid stenting is less commonly used to treat carotid artery stenosis than carotid endarterectomy, it’s still considered an effective and relatively low risk procedure. Carotid endarterectomy is a procedure that involves the surgical removal of plaque that’s built up inside the carotid artery.

Learn more about why this procedure may be recommended, who’s a good candidate for it, and what the procedure involves.

Carotid stenting is used to treat a condition called carotid artery stenosis, which is when plaque builds up on the inside of your carotid arteries, which are located on either side of your neck.

Plaque is made up of cholesterol, fat, and calcium. When it builds up to unhealthy levels, a condition called atherosclerosis develops, which means the arteries have become a lot narrower. This makes it more difficult for blood to flow properly through these blood vessels to get to your brain. Carotid artery stenosis increases your risk of stroke.

Some factors that can raise your risk of developing carotid artery stenosis include:

  • having high cholesterol
  • having diabetes
  • having high blood pressure (hypertension)
  • smoking
  • advanced age

According to a 2020 article, carotid stenting is usually recommended for people who have 50% stenosis along with symptoms, or people who have 70% stenosis but no symptoms.

Additionally, carotid stenting is usually recommended for people who need to avoid more invasive surgeries. This may include people who have:

  • congestive heart failure
  • serious pulmonary disease, such as COPD
  • experienced a recent heart attack
  • a history of previous neck radiation

Carotid stenting and carotid endarterectomy are the two main procedures used to treat carotid artery stenosis.

Most of the time, carotid endarterectomy is considered the preferred procedure to manage carotid artery stenosis. One of the reasons it’s often favored over carotid stenting is because stenting carries a higher risk of stroke immediately after the procedure.

With carotid endarterectomy, a small incision is made in the neck, and the internal carotid artery is identified. A clamp is then placed on the artery to temporarily halt blood flow while the surgeon makes an incision to open up the artery.

Once the artery is open, the surgeon manually removes the plaque that has accumulated inside the blood vessel. The artery is then closed with sutures. The procedure is more invasive than carotid stenting and usually requires general anesthesia.

But there are times when carotid stenting may be preferable. This may be due to the following reasons:

  • Less invasive: Carotid stenting is considered a minimally invasive procedure. It rarely involves general anesthesia and doesn’t involve a neck incision.
  • Lower risk of myocardial ischemia: Although carotid stenting has a higher risk of stroke, carotid endarterectomy may have an increased risk of myocardial ischemia (reduced blood flow to the heart due to a blockage in the heart’s arteries), compared with carotid stenting.
  • Shorter recovery time: Recovery time from carotid stenting is usually shorter than the recovery time for carotid endarterectomy.

Carotid stenting usually takes place in a hospital setting. Your healthcare professional will provide you with instructions about what you can and can’t do prior to the procedure, including when you should stop eating and drinking.

Shortly before the procedure starts, you’ll be given medication that will make you drowsy and relaxed.

Although there may be some variations, you can typically expect the following to happen during carotid stenting:

  • A catheter (thin, flexible tube) will be placed in one of your arteries, typically through a small incision in your groin area.
  • A filter basket will be added to this catheter to catch any plaque that is dislodged during the procedure.
  • Once the catheter reaches your carotid artery, a balloon will be inflated to help open up the clogged area in your artery.
  • Once the artery is inflated, a stent will be placed in the artery.
  • The catheter will then be removed, and the small incision will be closed.

Carotid stent surgery typically involves an overnight stay in the hospital. You’ll be carefully monitored to ensure you don’t show any signs or symptoms of a stroke or bleeding.

Once you’re cleared to go home, you’ll be given instructions about the activities you can and can’t do while you’re recovering and what medications you need to take.

There isn’t published research on how long it takes to recover from this procedure, but it usually involves a 24- to 48-hour stay in the hospital and about a week of rest at home.

Recovery time can vary from one person to another based on factors such as your age, overall health, and whether you have any other chronic health conditions.

The biggest risk associated with carotid stent surgery is that of a stroke immediately following the surgery. This can happen if a piece of plaque breaks away from the carotid artery wall during the procedure and travels to the brain.

According to a 2020 study, most strokes associated with carotid stenting are minor and not disabling. According to this study, the risk of stroke following the procedure is highest in people who are older than 70.

Other possible complications that may arise during carotid stent surgery include:

  • bleeding or infection at the site where the catheter is inserted
  • carotid artery dissection (tear in the artery)
  • carotid artery embolization (blood clot that becomes stuck in blood vessel)
  • failure of the stent to install correctly

Carotid stent surgery is considered a highly effective way to address carotid artery stenosis and reduce the risk of a stroke. In terms of long-term success rate, it’s considered equally as successful as carotid endarterectomy.

According to a 2019 study, both carotid stent surgery and carotid endarterectomy greatly reduced the risk of a stroke in the decade following these procedures. The authors of the study reported that in the 10 years following these procedures, the risk of a stroke was about 0.6%.

Carotid stent surgery is a procedure used to treat carotid artery stenosis, a condition that’s caused by the buildup of plaque in the carotid arteries. This condition can greatly increase your risk of a stroke.

Carotid stent surgery has a high success rate of reducing your risk of stroke. However, the procedure does have risks. For some people, a more invasive procedure called carotid endarterectomy may be a better option.

If you have carotid artery stenosis, talk with your doctor about the risks and benefits of carotid stent surgery and carotid endarterectomy.