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Carotid Angioplasty and Stenting
Carotid angioplasty and stenting (CAS) may be used as an alternative to carotid endarterectomy for some patients. It is based on the same principles as angiography done for heart disease.
- An extremely thin catheter tube is inserted into an artery in the groin.
- It is threaded through the circulatory system until it reaches the blocked area in the carotid artery.
- The doctor either breaks up the clot or inflates a tiny balloon against the blood vessel walls (angioplasty).
- After temporarily inflating the balloon, the doctor typically leaves a circular wire mesh (stent) inside the vessel to keep it open.
This procedure carries a risk for an embolic stroke and other complications. At this time, it is mainly used in some hospitals as an alternative procedure for patients who cannot undergo endarterectomy, especially for patients with severe stenosis (blockage greater than 70%) and high surgical risk. Some recent research has indicated that stenting may work as well as carotid endarterectomy in high-risk patients. However, other studies have found that stenting increases the risk of adverse effects. More research is under way.
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Review Date: 05/06/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
