Endovascular carotid or brain stenting

During Surgery

Once you are comfortably settled in the endovascular suite and pre-operative procedures are complete, your surgeon will make an incision in your groin (the area between the lower abdomen and upper thigh) after using a local anesthetic to numb the area. You also will be given medicine to help you relax as you must remain perfectly still throughout the procedure.

A small flexible tube (micro catheter) will be inserted through the incision in your groin into an artery. Your doctor will carefully guide the catheter up to the point where the artery is blocked. Live x-rays (fluoroscopy) will be used throughout the procedure to assist the doctor in guiding the catheter.

Once the catheter is in place, your doctor will pass a small wire with a balloon attached on the end up into the blockage. At this point the balloon will be blown up, pressing against the walls of the artery to open the artery and restore proper blood flow. The stent is then inserted, providing permanent support to the weakened walls of the blood vessel and allowing blood to flow normally. Most stents used today are self-expanding and conform to the artery walls. The stent will be left in place while the balloon and catheters are removed.

Post Surgery

After surgery, your doctor will require you to stay in the hospital overnight so you can be monitored for any signs of bleeding, stroke, or poor blood flow to your brain. You will be admitted to the neurological intensive care unit for close monitoring.

In general, following surgery you can expect to have a one-half inch nick in the groin, which may be tender to the touch. Clean the area with hydrogen peroxide or antibacterial soap daily and leave open to air. No soaking in salt water, pool or tub for 14 days, however showering is allowed after 24 hours. All strenuous activity must be avoided for one to two weeks.

Follow up care

You will be given specific instructions for medication from your doctor, but most patients can expect to take a daily dose of aspirin indefinitely, as well as Plavix for a minimum of three months for patients with carotid stents. You will be scheduled to follow up with your doctor four to six weeks after discharge. Additional follow up appointments at three months and 12 months will include updated imaging (Doppler US, CT scan, or MRI) as well as a visit with your doctor to assess your progress.

It is important to remember that one in every five individuals who have a stroke will go on to have a secondary or recurrent stroke, without surgical intervention. It is important to watch for signs of stroke and to actively pursue a healthier lifestyle to help reduce your risk of stroke in the future. Steps to a healthier lifestyle include:

• Stop smoking
• Regular exercise
• Maintaining a healthy weight
• Eating a healthy diet; watching sodium intact
• Maintaining a healthy blood pressure
• Taking all medication as directed