Carotid endarterectomy - Alternatives to carotid endarterectomy

Carotid endarterectomy is the main treatment for narrowing of the carotid arteries as it is very effective. However, there is also an alternative procedure called carotid artery stent placement, or "stenting".

Carotid artery stent placement

Carotid artery stent placement is less invasive than a carotid endarterectomy because it does not involve an incision being made in the neck.

Stenting is carried out under local anaesthetic and involves a narrow flexible tube called a catheter being inserted into an artery in your groin. It is then threaded up into the carotid artery using X-rays to guide it into place.

There is a small balloon at the end of catheter that is inflated to around 5mm at the site of the narrowed artery. A small mesh cylinder called a stent will then be inserted into the artery. The balloon will be deflated and removed, leaving the stent in place to keep the artery open and allow blood to flow through it.

After the procedure, you will need to lie flat and keep still for about an hour to prevent any bleeding from the artery. You will need to stay in hospital overnight, but will be able to return home the next day.

Like carotid endarterectomy, there are some risks associated with stenting. The risks of having another stroke or dying are the same for both procedures. As with carotid endarterectomy, stenting will therefore only be recommended if your carotid arteries become severely narrowed.

The National Institute for Health and Care Excellence (NICE) has confirmed that stenting is a safe procedure and has good short-term results, although the long-term effectiveness of the procedure is not yet known. NICE advises that, provided the risks of stenting are judged similar to those after surgery, it is safe to offer this alternative.