What is Carotid Angioplasty?

Carotid angioplasty is a minimally invasive surgery performed to improve blood flow in constricted carotid arteries. Utilized to reverse the effects of plaque-induced arterial narrowing, carotid angioplasty generally involves stent placement to ensure proper blood flow. Carotid angioplasty does carry risk for complications, including heart attack and recurrent blockage known as restenosis.

Generally requiring overnight hospitalization, carotid angioplasty is usually performed through a single incision in the groin. A local anesthetic is administered to the incision site where a balloon catheter is introduced into the affected artery. Fluoroscopy, a form of image-guided technology, and contrast material are used to ensure proper catheter placement within the targeted area of blockage in the neck.

Once the catheter is positioned, the balloon is inflated to remove the blockage and widen the passage. Pressure from the inflated balloon functions to press accumulated plaque against the artery's walls and out of the way. Before the balloon is deflated and withdrawn, a mesh stent is positioned where the blockage formed. Stent placement serves to reinforce weakened arterial walls and keep the passage open. Depending on type, the stent may possess a filter designed to capture displaced plaque and prevent complications.

Post-carotid angioplasty testing may be performed, including a carotid ultrasound, to evaluate arterial blood flow and the condition of the artery. Aside from a possible allergic reaction to contrast material, additional risks associated with carotid angioplasty may include infection, excessive bleeding at the incision site, and stroke. Individuals are usually monitored overnight and given home-care instructions prior to discharge regarding medication use and possible activity restrictions.

Located on either side of the neck, the carotid arteries deliver oxygenated blood to the brain. Arterial constriction can significantly impair the quantity and quality of blood flow placing an individual at risk for stroke. A distinct sound created by impaired blood circulation, known as a bruit, is often the only sign of carotid arterial constriction. In the absence of a bruit, a blockage within the carotid artery is generally detected during a carotid ultrasound. Upon discovery, a battery of additional tests, including a carotid angiography, may be performed to determine the extent of arterial narrowing.

Atherosclerosis is associated with the majority of cases of arterial disease necessitating carotid angioplasty. Patterned signs and symptoms of carotid arterial narrowing develop gradually over the long term and usually present with an interruption of blood flow. Signs including unilateral weakness, or weakness affecting one side of the body, and impaired cognition, speech or vision can be indicative of a transient ischemic attack (TIA) requiring immediate medical attention. Ideally, a diagnosis of carotid artery disease is confirmed and surgery performed before symptoms present or a TIA happens.

Carotid angioplasty should not be viewed as a treatment or cure for carotid artery disease. The procedure is performed to alleviate the effects of the disease and decrease one’s risk for stroke. Implementing dietary and healthy lifestyle changes, such as regular exercise, is essential to slowing the progression of plaque-induced arterial narrowing. Some individuals may also take medication, such as a cholesterol-lowering drug, upon their doctor's recommendation.