Carotid Artery Procedures After a Stroke or TIATopic OverviewWhen is a carotid artery procedure an option?You have two carotid arteries , one on each side of your neck. They carry blood to your brain. Narrowing ( stenosis ) in a carotid artery increases your risk of stroke. If you have had a stroke or transient ischemic attack (TIA) , your doctor may suggest that you have a carotid artery procedure to help lower your risk of a stroke. There are two types of carotid artery procedures: carotid endarterectomy surgery and carotid artery stenting. Endarterectomy is more common than stenting. Your doctor will check several things to see if a procedure is an option for you. These things include:
A doctor may give you the option of having a procedure, but this may not be not a clear-cut decision. How you feel about the risks and benefits is just as important as the medical facts. How are these procedures done?Carotid endarterectomy (say "kuh-RAW-tid en-dar-tuh-REK-tuh-mee") is surgery to remove plaque buildup from a carotid artery. During this surgery, a surgeon:
Carotid artery stenting is also called carotid angioplasty. It is similar to coronary angioplasty, which is done to open narrowed or blocked arteries in the heart. During this procedure, a doctor:
How well do carotid artery procedures work?
Timing is important in how well these procedures work. People may benefit most from a procedure if it is done within 2 weeks of the stroke or TIA. This is when the risk of another stroke is highest. What are the risks of carotid artery procedures?The risks of carotid endarterectomy include:
The risks of carotid stenting include:
Your chance of having a serious problem depends on things like your age and your overall health. Your doctor can help you understand your risk of problems from a procedure. It is important that your risk of stroke or death is less than 6%. footnote 4 It is also important to find a surgeon and a hospital that have experience in doing the procedure and have a low rate of serious problems.. Who should not have a carotid artery procedure?A carotid procedure is not advised for some people. For example, a procedure may not be an option if you have:
Are there other ways to reduce the risk of another stroke?Taking medicines and making healthy lifestyle changes are very important in preventing another stroke. These steps help control the conditions that increase your risk of stroke. Having a procedure does not take the place of these steps. If you decide to have a procedure, you will still need to take medicine and have healthy habits. Medicines that can help reduce the risk of stroke include:
Healthy habits that can help reduce the risk of stroke include:
References
Credits
ByHealthwise Staff Current as ofOctober 5, 2017
Current as of: October 5, 2017 Author: Healthwise Staff Medical Review: Adam Husney, MD - Family Medicine & Robert A. Kloner, MD, PhD - Cardiology Rerkasem K, Rothwell PM (2011). Carotid endarterectomy for symptomatic carotid stenosis. Cochrane Database of Systematic Reviews (4).
Brott TG, et al. (2010). Stenting versus endarterectomy for treatment of carotid-artery stenosis. New England Journal of Medicine, 363(1): 11-23.
Bonati LH, et al. (2012). Percutaneous transluminal balloon angioplasty and stenting for carotid artery stenosis. Cochrane Database of Systematic Reviews (9). DOI: 10.1002/14651858.CD000515.pub4. Accessed September 12, 2014.
Kernan WN, et al. (2014). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(7): 2160-2236. DOI: 10.1161/STR.0000000000000024. Accessed July 22, 2014.
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