Your physician has told you that an artery in your neck that supplies blood to your brain is too narrow. Some cholesterol plaques are lining the walls of your artery and causing a decrease in the normal blood flow to your brain. This increases your chances of having a stroke. Your physician has recommended a procedure called angioplasty and stenting to repair that narrowing. Carotid stenting is a procedure that is used with balloon angioplasty to open up a narrowed carotid artery. After placement, the carotid stent becomes a permanent implant to hold the artery open and allow a good blood flow to your brain. The carotid stent is a small, slotted stainless steel tube that comes in different sizes to match the size of your artery.
- Do not eat or drink from midnight on, the day of your procedure.
- A medication may be prescribed to decrease the risk of blood clots forming.(ex. Aspirin)
- A member of your family may accompany you.
- When you arrive at the Hospital, you will be directed to the Radiology department where a nurse will take care of you.
- The Neuro-radiologist and the Anesthetist will explain the procedure to you and ask you to sign the consent form.
- A radiology nurse will accompany you throughout the procedure.
- An intravenous will be put in your arm, a cardiac monitor will be placed, a blood pressure cuff put on your arm and a urinary catheter inserted.
- You will be awake during the procedure so that you can tell us if you feel anything wrong (visual problems, weakness of extremeties, numbness, confusion).
- You have to lie down on your back for at least 2 hours.
- The equipment used will be explained to you.
- You will first be given a local anesthetic in your groin and an introducer (like a small tube) will be inserted into the blood vessel. This is the entry for various catheters. The first 5 minutes are uncomfortable but after this you will feel only pressure in your groin area.
- X-ray pictures of your blood vessels will then be done by injecting a special dye through a catheter. You may feel a warm sensation when the dye is injected.
- A special balloon catheter is then inserted and inflated at the level of your stenosis (narrowing of your blood vessel).
- The stent is then threaded to the same level and placed there.
- Another balloon catheter opens the stent and push it against the walls of your artery to open the stenosis.
- The balloon catheter is removed and another x-ray picture of your blood vessels is done.
- The introducer will remain in your groin for 24 hours.
AFTER THE PROCEDURE
- You will remain in the recovery room for about 24 hours with the introducer in your groin. You must not bend your leg, but the head of your bed can be raised up to 30 to 40 degrees.
- When the introducer is removed from your groin, a pressure dressing is applied for about 12 hours. At this time, we can transfer you to your room.
- The intravenous can be taken out 4 hours later.
- The nurse will check you frequently and also check the pressure dressing for bleeding or swelling. The pulse in your foot will be checked to ensure a good circulation of blood in your leg.
- You must remain in bed for at least 24 hours after the introducer has been removed. However, you can get up to the bathroom after the first 6 hours.
- You can usually go home the next day (48 hours after the procedure).
- It is very important to take the blood-thinning medication your physician has prescribed for you. (Entrophen (coated Aspirin) and Coumadin). These medications prevent blood clots from forming and attaching to your stent.
- If you are prescribed Coumadin, you will have to have blood tests to regulate the dosage. You will be given precise instructions to follow.
- This medication to thin your blood can make you bleed for longer periods if you hurt yourself or can cause you to bruise easily. Tell your physician if you have any blood in your urine and/or your stools. Don’t stop taking these medications before you check with your physician.
Before you will leave the hospital, a dietician will meet you and give you a diet low in fat and cholesterol. You should follow this diet to decrease the risks of atherosclerosis.
- During the first week, don’t lift heavy objects. The femoral artery needs time to heal well.
- You can walk short distances every day.
- Increase your activity every day and listen to your body for signs of fatigue.
- Your physician will tell you when you may return to work and do your regular activities.
Note: You must inform medical staff that you have a stainless steel implant before having any special tests. Magnetic Resonance Imaging could move the stent.
Information about InfoNEURO
Neuro-Patient Resource Centre
Montreal Neurological Hosptial Room 354
Tel: (514) 398‑5358
Web site: http://infoneuro.mcgill.ca/
This information is for educational purposes only, and is not intended to replace the advice of a professional healthcare practitioner, or to substitute for medical care.
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Neuro-Radiology Department of the Montreal Neurological Hospital. Sept.1998.