Common Questions About Carotid Artery Stenting for Stroke Patients

Carotid Stenting Overview

You have two carotid arteries, one on each side of the neck, which carry blood from the face to the brain. When one of those arteries becomes blocked, this can put you at risk of a stroke. This is usually due to plaque. A small mesh tube called a stent can be inserted within the blocked artery to improve blood flow.

The procedure is far less invasive than surgery using a catheter with a small balloon, usually starting at the groin, to open the blockage to the artery. The stent is then inserted to prevent the artery from narrowing again, after which the balloon and catheter are removed.

Because carotid stenting is a minimally invasive procedure, general anesthesia may not be needed. However, IV fluids and medication are given to relax the patient. You and your doctor will decide whether you need anesthesia or remain awake by being  numbed.

Carotid stenting is generally recommended if you have had a stroke if more than 70% of the artery is blocked, or if you have received a carotid endarterectomy previously and are experiencing restenosis, or new narrowing since surgery. Additionally, stenting can address multiple blockage locations at one time. Understanding the procedure is important, but it is equally important to understand why carotid stenting may be recommended in the first place. Our Carotid Artery Disease Decision-Making Guide explains how specialists evaluate carotid artery disease and decide when treatment is appropriate.

What Does a Stroke Specialist Do for Carotid Stenting

To decide on your best treatment path, your healthcare professional will review your medical history and perform a physical examination. He may order an ultrasound, an MRA (magnetic resonance angiography) a CGA (computerized tomography angiography), or a carotid angiography.

If you and your doctor agree that carotid stenting is your best treatment option, a date will be set for your procedure. You will receive instructions as to what you can or cannot eat and drink before the procedure. You may also be instructed to stop specific medications such as blood thinners or anti-inflammatory drugs.

The procedure itself entails:

• Local anesthesia given.
• A catheter is inserted through a small incision in the groin.
• The catheter is inserted and guided up to reach the blockage area in the carotid artery.
• A filter is inserted to prevent any further blockage.
• The small balloon with the catheter is inflated expanding the walls of the blood vessel, and the stent is inserted as the carotid artery opens.
• The balloon, filter, and catheter are then removed and the stent stays.
• The incision site is closed and the proper dressing is applied.

Duration of the Carotid Stenting Procedure

Once the anesthesia is given, the carotid stent procedure is generally done within 30 minutes to two hours. However, if your arteries are narrow, it may take longer to thread the catheter up to the carotid blockage. Or, if the artery is difficult to access, this could also add to the time. Rest assured your doctor is taking his time to ensure a positive result from your procedure and make sure you are comfortable.

Carotid Stenting Recovery

In the recovery room, you will need to lie still for several hours. You may receive another ultrasound during this time. You will stay overnight so the healthcare team can monitor your recovery.

If no general anesthesia is used and no complications occur, most patients are discharged within 24 hours following carotid stenting. Typically, many patients can walk within a few hours post surgery.

You can expect some swelling and bruising at the catheter site for a few days. You should avoid strenuous activity during this time and no heavy lifiting for two days. You may be prescribed pain medication.

Full recovery can be expected within 3 to 4 days and back to full activity within a week. Your healthcare provider will contact you to schedule a follow-up appointment. For one week you will need to make modifications for recovery and lifestyle changes such as stopping smoking and following a health diet and exercise.

When to See a Carotid Artery Specialist

Carotid artery disease often develops gradually and may not cause symptoms until a stroke or transient ischaemic attack (TIA) occurs. Early specialist assessment can help determine whether medical management, monitoring or intervention is appropriate.

Consider seeing a vascular or neurointerventional specialist if you:

• Have experienced a stroke or TIA
• Have been diagnosed with carotid artery narrowing on ultrasound, CT angiography (CTA) or MR angiography (MRA)
• Have significant cardiovascular risk factors, including high blood pressure, diabetes or smoking
• Have been advised that you may need carotid artery stenting or carotid endarterectomy
• Would like a second opinion regarding carotid artery treatment
• Have questions about minimally invasive alternatives to surgery

A specialist consultation typically includes reviewing your brain and vascular imaging, assessing your stroke risk and discussing whether medical therapy, carotid artery stenting or surgery is the most appropriate option. Patients also receive guidance on long-term stroke prevention, medications and follow-up care.

Seek emergency medical attention immediately if you experience sudden facial drooping, weakness or numbness on one side of the body, difficulty speaking, sudden vision loss, severe dizziness or loss of balance. These symptoms may indicate a stroke and require immediate medical treatment.

Your Carotid Stenting Specialist in Singapore

If you are suffering symptoms of carotid blockage or a stroke such as blurred vision, numbness or weakness on one side of your body, or sudden confusion, memory loss, or speech problems, call 9-9-5 at once. Contact our stroke specialist in Singapore, Dr. Manish Taneja at Supreme Vascular and Interventional Clinic for an immediate consultation. We are here for you in your time of need.

Stroke Resources

Stroke in Younger Adults

Areas of the Brain Affected by Stroke

We've Got You Covered for Specialized Stroke Screening, Prevention, and Management

Imagine heart attacks where the blood flow to your heart is blocked. Similarly, a stroke occurs when the blood flow to your brain is interrupted becoming a "brain attack". When blood supply does not reach a certain part, brain cells begin to die. Different types of stroke include ischemic strokes (blockage of blood vessel due to blood clot) or a mini stroke, a TIA (transient ischemic attack), with no permanent damage yet serious. Stroke also occurs when a blood vessel in the brain pops causing bleeding in the brain.

When a stroke occurs, the symptoms of stroke depend on how blood flow to the brain is affected. Individuals at high risk and even higher risk (family history) often have high blood pressure, atrial fibrillation, or another risk factor for stroke, all of which increase the risk of stroke.  Disrupted blood flow can  even damage the blood vessel in the brain and affect one side of the body. Having a stroke doesn’t mean it has to lead to permanent disabilities. Recognizing early warning signs is essential to reduce the risk, and in some cases, procedures such as carotid endarterectomy may help increase the blood vessel in the brain and restore healthy circulation.

Certain areas of the brain can be affected by stroke and some symptoms of a stroke including cardiovascular disease, diabetes, and high blood sugar levels increase the risk of stroke whereas an active lifestyle or controlling high cholesterol reduces the risk. How well do you know stroke? Find tips to prevent and manage stroke, the differences in stroke screening tests, and the newer technology and treatments available. Come in for an easy consultation and further evaluation with our stroke specialist in Singapore at the Supreme Vascular and Interventional Clinic. 

Supreme Vascular and Interventional Stroke Programs

Neurointerventional / Stroke Treatments

Brain Aneurysm

The Supreme Vascular and Interventional Clinic is your "go-to" facility for various neurointerventional / stroke conditions and treatments. To arrange an appointment with Dr. Manish Taneja, our stroke specialist, contact us. You can also call us at (+65) 6904 8084 for a consultation.