Carotid Artery Stenting
Learn about Carotid Artery Stenting in Singapore, a minimally invasive treatment for selected carotid artery narrowing. Understand how stenting works, who may benefit, risks, recovery and specialist care provided by Dr. Manish Taneja at the Supreme Vascular and Interventional Clinic.
Carotid Artery Stenting in Singapore
Minimally Invasive Treatment for Selected Carotid Artery Narrowing
Carotid artery stenting is a minimally invasive endovascular procedure used to treat selected patients with narrowing of the carotid arteries, the major blood vessels that supply blood to the brain.
Carotid artery narrowing, also known as carotid artery stenosis, is commonly caused by the build-up of fatty deposits called plaque within the artery. Significant narrowing can reduce blood flow to the brain and may increase the risk of stroke.
During carotid artery stenting, a specialist guides a catheter through the blood vessels to the narrowed section of the carotid artery. A small mesh stent is then positioned to widen and support the artery, helping improve blood flow to the brain.
At the Supreme Vascular and Interventional Clinic, carotid artery stenting forms part of a comprehensive vascular and neurointerventional care pathway led by Dr. Manish Taneja, a dual-trained neurointerventional and peripheral vascular intervention specialist.
Our brain-to-body approach allows vascular conditions affecting the carotid arteries and wider circulation to be considered within a broader understanding of the patient's vascular health.
Treatment Overview
| Treatment Type | Minimally invasive endovascular procedure |
|---|---|
| Also Known As | Carotid stenting, carotid artery angioplasty and stenting |
| Used for | Selected patients with significant carotid artery narrowing |
| Specialty | Vascular and neurointerventional care |
| Treatment goal | Improve blood flow through the narrowed carotid artery and reduce stroke risk in appropriately selected patients |
| How it works | A balloon may widen the narrowed artery before a mesh stent is placed to support the artery |
| Procedure Access | Catheter inserted through the wrist or groin |
| Anaesthesia | Depends on the individual procedure and clinical circumstances. General anesthesia may not be needed. However, IV fluids and medication are given to relax the patient. |
| Follow-Up | Clinical review and vascular imaging may be recommended |
| Performed By | Dr. Manish Taneja, dual-trained neurointerventional and peripheral vascular intervention specialist |
What Is Carotid Artery Stenting?
Carotid artery stenting is a minimally invasive procedure used to open and support a narrowed carotid artery.
The carotid arteries are located on either side of the neck and supply oxygen-rich blood to the brain. When plaque builds up inside a carotid artery, the artery can become narrowed and potentially increase the risk of stroke.
During stenting, a catheter is guided through the blood vessels to the narrowed section of the carotid artery. The narrowed area may first be widened using angioplasty, followed by placement of a small mesh stent.
The stent remains in the artery and acts as a scaffold, helping keep the blood vessel open and allowing blood to flow more freely towards the brain.
Carotid artery stenting is not suitable for everyone with carotid artery disease. Treatment decisions depend on the degree and location of narrowing, symptoms, overall health, anatomy and the individual's risk factors.
How Does Carotid Artery Stenting Work?
Opening and Supporting the Narrowed Carotid Artery
Before treatment, detailed imaging is used to assess the carotid arteries and determine the location and severity of narrowing. During the procedure, a thin catheter is carefully inserted in the groin or wrist then guided through the blood vessels towards the affected carotid artery. A specialised protection system may be used to help reduce the risk of plaque or debris travelling towards the brain during treatment. The narrowed section may then be widened using a small balloon. A mesh stent is subsequently positioned across the narrowed area to support the artery and maintain its opening.
Once the stent is securely positioned, the catheter and other temporary equipment are removed while the stent remains in place. Imaging is used throughout the procedure to guide treatment and assess blood flow through the carotid artery.
It is important to remember: Carotid artery stenting treats narrowing within the artery itself by opening and supporting the blood vessel, helping restore blood flow to the brain.
When Might Carotid Artery Stenting Be Recommended?
Carotid artery stenting may be considered for selected patients with significant carotid artery stenosis, particularly when an endovascular approach may be appropriate.
Your specialist will consider:
- The degree of carotid artery narrowing
- Whether you have experienced symptoms such as a transient ischaemic attack or stroke
- The location and anatomy of the narrowing
- Your overall health
- Your risk of stroke
- Your suitability for carotid surgery or other treatment approaches
- The potential benefits and risks of intervention
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. Unlike most other causes of stroke, carotid artery dissection is more likely to occur in young adults under the age of 50.
Not everyone with carotid artery narrowing requires a stent. Some patients may be managed with medication and lifestyle measures, while others may be considered for surgical carotid endarterectomy or another treatment depending on their individual circumstances. A detailed vascular assessment is therefore essential before deciding whether carotid artery stenting is appropriate.
Carotid Artery Stenting vs Carotid Endarterectomy
Understanding Your Treatment Options
Both carotid artery stenting and carotid endarterectomy aim to treat significant carotid artery narrowing, but they use different approaches.
| Carotid Artery Stenting | Carotid Surgery (Endarterectomy) |
|---|---|
| Minimally invasive endovascular procedure | Open surgical procedure |
| Catheter is guided through the blood vessels | Surgeon accesses the carotid artery through an incision in the neck |
| A stent supports the narrowed artery | Plaque is surgically removed from the artery |
| No neck incision is required for the stent procedure | Requires surgical access to the carotid artery |
| May be appropriate for selected patients based on anatomy and clinical circumstances | May be preferred for certain patients depending on their individual risk and anatomy |
The most appropriate treatment depends on your individual condition, anatomy, stroke risk and assessment by your treating specialist.
Why Is Individualised Assessment Important?
Carotid Narrowing Does Not Always Require a Procedure
The discovery of carotid artery narrowing does not automatically mean that a stent or surgery is required.
Treatment decisions consider the degree of stenosis, whether symptoms have occurred, the characteristics of the plaque, your overall health and your risk of future stroke.
Your specialist may recommend:
- Medical management
- Lifestyle and risk-factor modification
- Carotid artery stenting
- Ongoing imaging and monitoring
The aim is to select the treatment that provides the most appropriate balance between potential benefit and risk for your individual circumstances. CAD and stroke management treatment options differ from one individual to another depending upon age, other health conditions, and to aid in stroke prevention. In some cases of CAD without stroke, time and rest may be all that is required. But in other cases, and if a stroke has occurred, some treatment recommendations may include:
- Blood pressure medication
- Blood sugar medication including insulin
- Blood thinners including anticoagulants
- Aspirin
- Other over-the-counter pain medication
- Surgery or carotid stenting
Potential Benefits of Carotid Artery Stenting
Improving Blood Flow Through a Narrowed Artery
For appropriately selected patients, carotid artery stenting may provide several potential benefits.
Minimally Invasive Treatment
The procedure is performed through the blood vessels using catheter-based techniques rather than open surgery.
Supports the Narrowed Artery
The stent provides structural support to help maintain the opening of the treated carotid artery.
Improves Blood Flow
Opening the narrowed section can improve blood flow through the carotid artery towards the brain.
An Alternative to Open Surgery
For selected patients, carotid artery stenting may provide an alternative treatment approach to carotid endarterectomy.
It is important to remember: Every patient is different. The potential benefits of carotid artery stenting must be considered alongside the risks, anatomy and alternative treatment options.
What Are the Potential Risks and Limitations?
Understanding the Risks of Carotid Artery Stenting
Like all vascular procedures, carotid artery stenting carries potential risks.
Potential risks may include:
- Bleeding or bruising at the catheter access site
- Blood vessel injury
- Reaction to contrast dye
- Changes in blood pressure or heart rate
The level of risk varies depending on the severity and location of the narrowing, the patient's anatomy, medical history and overall health.
Your specialist will discuss the potential benefits, risks and alternatives before treatment.
Recovery After Carotid Artery Stenting
What Can You Expect After Treatment?
Following carotid artery stenting, you will be monitored to assess your neurological condition, blood pressure and the catheter access site.
Your recovery will depend on your individual circumstances and whether you have experienced symptoms such as a TIA or stroke before treatment.
Your specialist will provide personalised advice regarding:
- Caring for the catheter access site
- Prescribed medications
- Returning to normal activities
- Follow-up appointments
- Follow-up vascular imaging
- Managing cardiovascular risk factors
Long-term management may also include medication, lifestyle changes and monitoring to help reduce the risk of future vascular events. 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.
Your Carotid Artery Stenting Treatment Journey
| Step | Stage | Description |
|---|---|---|
| 1 | Specialist Consultation & Assessment | Review your symptoms, medical history and previous vascular investigations. |
| 2 | Imaging & Carotid Assessment | Assess the degree, location and characteristics of carotid artery narrowing. |
| 3 | Treatment Planning | Discuss stenting, surgery, medical management and other appropriate options. |
| 4 | Carotid Artery Stenting | Place a stent within the narrowed artery using minimally invasive techniques. |
| 5 | Recovery & Monitoring | Monitor your neurological condition, blood pressure and access site after treatment. |
| 6 | Follow-Up & Prevention | Continue specialist follow-up, imaging and management of vascular risk factors. |
Why Choose the Supreme Vascular and Interventional Clinic for Carotid Artery Stenting?
Brain-to-Body Vascular Expertise Under One Roof
Carotid artery disease sits at the intersection of vascular and neurological health. Treatment requires an understanding of both the blood vessel and the brain it supplies.
At the Supreme Vascular and Interventional Clinic, care is led by Dr. Manish Taneja, a dual-trained neurointerventional and peripheral vascular intervention specialist.
Brain-to-Body Expertise
Specialist expertise spans vascular conditions affecting both the brain and wider circulation.
One Specialist Throughout Your Care
Receive continuity from assessment and treatment planning through your follow-up care.
Minimally Invasive Treatment
Where appropriate, catheter-based treatment can address carotid narrowing without open surgery.
Advanced Imaging
Detailed vascular imaging supports accurate assessment and treatment planning.
Continuum of Care
From diagnosis and treatment decisions to follow-up and vascular risk management, care is approached as a continuous treatment journey.
Frequently Asked Questions About Carotid Artery Stenting
Does carotid artery narrowing always require a stent?
No. Some patients may be managed with medication and lifestyle changes, while others may require intervention depending on the degree of narrowing, symptoms and individual stroke risk.
Who may benefit from carotid artery stenting?
Selected patients with significant carotid artery narrowing may benefit from stenting. Suitability depends on symptoms, anatomy, medical history and comparison with other treatment options.
Is carotid artery stenting minimally invasive?
Yes. The stent is delivered through a catheter inserted into the blood vessels, avoiding the need for open surgical access to the carotid artery.
What is the difference between carotid stenting and carotid surgery?
Carotid stenting uses a catheter to place a stent inside the narrowed artery, while carotid endarterectomy is an open surgical procedure that removes plaque from the artery.
How long is the carotid artery stenting procedure?
The procedure usually takes from 30 minutes to 2 hours and most people have to stay in the hospital for a day or two.
What happens after carotid artery stenting?
Patients are monitored after treatment and receive personalised advice about medication, activity, follow-up and management of vascular risk factors.
Will I need medication after carotid artery stenting?
Medication is commonly prescribed as part of treatment and stroke prevention, but the specific medication plan depends on your individual circumstances.
How long does a carotid stent remain in place?
The stent is designed to remain permanently within the carotid artery and provide ongoing structural support.
Specialist Assessment for Carotid Artery Stenting in Singapore
Carotid artery narrowing requires careful assessment before deciding whether intervention is appropriate.
At the Supreme Vascular and Interventional Clinic, Dr Manish Taneja provides specialist evaluation, advanced vascular imaging review and personalised treatment planning for patients with carotid and other vascular conditions.
With expertise spanning the brain and body, our specialized clinic provides a continuum of minimally invasive vascular care under one roof. If you have been diagnosed with carotid artery narrowing, referred for treatment or are seeking a specialist second opinion, our team can help you understand your condition and available treatment options.
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