| Venous Surgery | Carotid Surgery | Aneurysm Surgery | | Sympathectomy | Vascular Reconstructions | General Surgery | CAROTID ANGIOPLASTY AND STENTING Go back. Carotid angioplasty and stenting is a minimally invasive alternative to the operation of carotid endarterectomy. Instead of an incision in the neck, the femoral artery in the groin is punctured with a needle and specialised vascular catheters are passed, under x-ray control, through the aorta to gain access to the carotid arteries in the neck. A balloon catheter is positioned across the narrowed artery and the balloon is inflated to stretch open the artery. A metal framework called a stent is inserted at the same time to keep the stretched artery open when the balloon is deflated and removed. Admission - Depending on arrangements you will attend the radiology (x-ray) department where the procedure will be performed. After the procedure you will be admitted to the ward for observations overnight. The x-ray staff will explain the procedure to you and you will be asked to sign a consent form. You should not have anything to eat or drink for 6 hours before your procedure. Anaesthesia - Generally the procedure of carotid angioplasty and stenting is performed under local anaesthetic – you will be awake during the procedure. Local anaesthetic will be infiltrated into the skin of your groin on the side where the radiologist/surgeon decides to puncture the artery. Occasionally the procedure is performed in the operating theatre under general anaesthetic. Procedure - A cannula will be inserted into a vein on the back of your hand and various monitors will be attached to monitor your breathing pulse and blood pressure. The femoral artery in the groin is punctured with a needle and specialised vascular catheters are passed, under x-ray control, through the aorta to gain access to the carotid arteries in the neck. A balloon catheter is positioned across the narrowed artery and the balloon is inflated to stretch open the artery. A metal framework called a stent is inserted at the same time to keep the stretched artery open when the balloon is deflated and removed. At the end of the procedure the catheters and wires are removed and the doctor will press on your groin until the hole in your artery has sealed – usually 10-20 minutes. After the Procedure - You will be monitored in the recovery area and the ward for the rest of the day. The nurse will check your breathing pulse and blood pressure and ask you questions to check you are awake and ask you to perform certain tasks. If all is well after a few hours you will be allowed to eat and drink. The follwing day you may go home. Once at home - You will probably need 1-2 weeks off work, teurning when you feel comfortable. Avoid driving until the pain in your groin has subsided and you can control the vehicle normally. Gentle exercise is good e.g. walking, but avoid heavy lifting and straining for as long as possible. You may resume sex after six weeks. Complications of Carotid Artery Angioplasty and Stenting - There is a small risk of stroke at the time of the procedure (approximately 5-6%). During the procedure small pieces of plaque and clot can be dislodged which can then lodge in the arteries of the brain causing a stroke. Modern equipment tries to prevent this from occurring by inserting a filter into the artery but as yet the efficacy of these techniques is unproven. At present the complications of carotid angioplasty/stenting are higher than for the operation carotid endarterectomy, however, angioplasty/stenting may be the safer option for certain patients. Your doctor will explain why a certain technique has been recommended to you. The hole in the artery in the groin may bleed leading to haemorrhage, false aneurysm or bruising. Occasionally the nerve to leg may be damaged. Follow-up - Following discharge we will make arrangements to follow you up in the outpatient clinic in 6-8 weeks time. The practice of medicine and surgery is not an exact science and reputable practitioners cannot properly guarantee results either expressed or implied. These procedures are highly advanced and discussion about them (including risks and benefits) should be with your specialist.