Stroke is one of the leading causes of death and long-term disability worldwide. According to the World Health Organization, millions of people suffer strokes every year, and a large percentage of them are linked to carotid artery disease—a condition where fatty deposits (plaque) narrow the carotid arteries that supply blood to the brain.
Traditionally, such blockages were treated with carotid endarterectomy (open surgery). However, advancements in interventional radiology have introduced a safer, minimally invasive option: Carotid Stenting.
Carotid stenting involves placing a small metal mesh tube (stent) inside the carotid artery to keep it open, restore blood flow, and reduce the risk of stroke. This procedure is performed by an Interventional Radiology Specialist using image-guided techniques and is often recommended for patients who are at high risk for open surgery.
In this blog, we will dive deep into what carotid stenting is, why it’s done, how it’s performed, its benefits, risks, recovery process, and why consulting an experienced interventional radiology specialist is crucial.
What Is Carotid Stenting?
Carotid Stenting, also known as Carotid Artery Stenting (CAS), is a minimally invasive procedure used to treat narrowing (stenosis) of the carotid arteries.
The carotid arteries are two major blood vessels located on either side of the neck. They are responsible for supplying oxygen-rich blood to the brain. When these arteries become narrowed due to atherosclerosis (plaque buildup), the risk of stroke increases significantly.
During the stenting procedure:
- A catheter is inserted through the femoral (groin) or radial (wrist) artery.
- The catheter is guided to the carotid artery.
- A balloon angioplasty is performed to open the artery.
- A stent (metal mesh tube) is placed to keep the artery open permanently.
This restores blood flow and significantly lowers the risk of stroke.
Why Is Carotid Stenting Performed?
Doctors recommend carotid stenting when patients are at risk of stroke due to severe narrowing of the carotid arteries.
Common Indications:
- Severe Carotid Artery Stenosis (70% or greater narrowing).
- Moderate Carotid Artery Stenosis (50–69%) in symptomatic patients.
- History of Stroke or Transient Ischemic Attack (TIA).
- High Surgical Risk Patients who cannot undergo carotid endarterectomy.
- Restenosis (narrowing again after previous surgery).
In many cases, carotid stenting is life-saving because it prevents recurrent strokes in high-risk patients.
Symptoms of Carotid Artery Disease
Many people with carotid artery narrowing have no symptoms until the blockage becomes severe. Some warning signs include:
- Sudden weakness or numbness in face/arms/legs (usually one side).
- Trouble speaking or understanding speech.
- Sudden vision loss in one eye.
- Dizziness or loss of balance.
- Severe headache (in case of stroke).
If you experience these symptoms, you should immediately consult a doctor and may be referred to an interventional radiology specialist.
How Is Carotid Stenting Performed?
Carotid stenting is usually done in a specialized angiography suite under local anesthesia with mild sedation.
Step-by-Step Procedure:
- Preparation
- Patient is connected to monitors.
- Local anesthesia is applied to the catheter site (groin or wrist).
- Catheter Insertion
- A catheter is inserted into the artery.
- Guided to the carotid artery under fluoroscopy (X-ray imaging).
- Angiography
- Contrast dye is injected to visualize the blockage.
- Balloon Angioplasty
- A small balloon is inflated to widen the narrowed artery.
- Stent Placement
- A self-expanding stent is deployed to hold the artery open.
- Completion
- Catheter is removed.
- Puncture site is sealed with pressure or closure device.
The procedure typically takes 1–2 hours. Most patients go home within 24–48 hours.
Benefits of Carotid Stenting
- ✅ Minimally Invasive – No open surgery required.
- ✅ Stroke Prevention – Restores blood flow, reducing stroke risk.
- ✅ Quick Recovery – Most patients resume normal activities within a week.
- ✅ Suitable for High-Risk Patients – Especially those with heart disease, prior neck surgery, or advanced age.
- ✅ Durable Results – Stents can remain effective for years.
Risks and Complications
Though carotid stenting is safe, some risks include:
- Minor bruising or bleeding at catheter site.
- Stroke (rare, but possible during the procedure).
- Allergic reaction to contrast dye.
- Restenosis (re-narrowing of artery).
- Embolization (small plaque particles dislodging).
Use of embolic protection devices (tiny filters placed during the procedure) helps reduce stroke risk.
Recovery After Carotid Stenting
- Hospital stay: Usually 1–2 days.
- Medications: Patients are prescribed antiplatelet drugs (like aspirin and clopidogrel) to prevent clots.
- Activity: Avoid heavy lifting for 1 week. Normal routine can resume in a few days.
- Follow-up: Regular scans (ultrasound or angiography) to monitor stent function.
Carotid Stenting vs. Carotid Endarterectomy
| Aspect | Carotid Stenting | Carotid Endarterectomy (CEA) |
|---|---|---|
| Invasiveness | Minimally invasive (catheter) | Open neck surgery |
| Anesthesia | Local | General or local |
| Recovery Time | Few days | Weeks |
| Best For | High-risk surgical patients | Low-risk patients |
| Scarring | Tiny puncture mark | Neck scar |
Both procedures are effective, but carotid stenting is a preferred choice for patients who are older, medically fragile, or previously operated on the neck.
Role of Interventional Radiology Specialist in Carotid Stenting
An Interventional Radiology Specialist is the key expert who:
- Navigates the catheter safely to the carotid artery.
- Deploys the stent with precision.
- Monitors blood flow during and after the procedure.
- Minimizes risks using embolic protection devices.
Their expertise ensures the highest level of safety and success.
Dr. Alok Kumar Udiya – Expert in Carotid Stenting
In India, Dr. Alok Kumar Udiya at CARE CHL Hospital, Indore, is a leading Interventional Radiology Specialist with extensive experience in Carotid Stenting, Aneurysm Coiling, Mechanical Thrombectomy, and other neurovascular interventions. His use of advanced techniques and patient-centered care has made him a trusted name in preventing strokes through minimally invasive treatments.
Future of Carotid Stenting
With advancements in stent technology, embolic protection devices, and imaging systems, carotid stenting is becoming even safer and more effective. Emerging innovations include:
- Drug-eluting stents to reduce restenosis.
- AI-assisted imaging for precision navigation.
- Robotic-assisted interventional radiology.
FAQs on Carotid Stenting
Q1. Is carotid stenting painful?
No, patients feel minimal discomfort due to local anesthesia.
Q2. How long does a carotid stent last?
Many stents last for decades with proper care and medication.
Q3. Is hospitalization required?
Yes, usually 1–2 days.
Q4. Who should not get a carotid stent?
Patients with complete carotid artery blockage or certain medical conditions may not be suitable.
Q5. What is the success rate?
Carotid stenting has a success rate of over 95% when performed by skilled specialists.
Conclusion
Carotid Stenting is a revolutionary, minimally invasive procedure that significantly reduces the risk of stroke in patients with carotid artery disease. Safer than open surgery for many high-risk patients, it offers quick recovery, fewer complications, and long-term protection against stroke.
By choosing an experienced Interventional Radiology Specialist, patients can ensure the best outcomes. In India, experts like Dr. Alok Kumar Udiya are making advanced treatments like carotid stenting more accessible, helping save lives and prevent disabilities caused by stroke.
If you or a loved one has been diagnosed with carotid artery disease, consult your doctor today about the possibility of carotid stenting.