About Carotid and Vertebral Arteries
The carotid and vertebral arteries pass through the neck to supply blood to brain, brainstem and upper spinal cord. . The two carotid arteries are located in the front of the neck on either side of the throat. The vertebral arteries are located further back in the neck and are mostly contained within the bony channels of the cervical spine.
Carotid and vertebral arteries of the head or neck may become narrowed (stenosed) or completely blocked from atherosclerosis. Atherosclerosis is a disease where fatty deposits, called plaque, collect on the inside of the blood vessels. As atherosclerosis progresses, it may cause progressive narrowing of the vessel and reduce blood flow to the brain. It is also possible for pieces of plaque to break off and lodge in smaller blood vessels downstream. This may result in a stroke, or transient ischemic attacks (“mini-strokes”).
What is Artery Stenting?
By restoring or enhancing blood flow through narrowed carotid or vertebral arteries, the risk of a potentially life-threatening stroke may be reduced or prevented. Surgery to remove the plaque from the artery has been the traditional treatment for restoring blood flow to the carotid arteries. A newer FDA-approved procedure, carotid artery stenting, is a minimally-invasive technique that provides an alternative to surgery. Vertebral artery narrowing cannot be treated surgically and has been effectively treated with stenting for many years.
With stenting, a self-expanding mesh tube is placed within the artery at the site of the narrowing. When placed in the vessel, the outward force of the stent will reduce or completely eliminate the narrowing in the vessel. This technique can be applied to vessel narrowing both in the neck and within the skull.
Carotid and vertebral stents remain permanently in place. They are made of stainless steel or other metal alloys that resist rust. They are not noticed by metal detectors.
Surgery vs. Stenting
Carotid and vertebral artery stenting are much less invasive than surgery. Patients usually have a shorter recovery time. While stenting may be a better option than surgery for many patients, it is not appropriate for all patients. This will be determined by the team of doctors treating you. Some reasons why your doctors may select stenting over surgery are:
- You are considered high risk for surgery.
- You cannot undergo general anesthesia.
- You developed new narrowing in the artery after previous carotid surgery (i.e.:”re-stenosis”).
- Patients who are deemed suitable for a stent will undergo a comprehensive consultation by an interventional neuroradiologist. A more detailed explanation of the procedure and risks will be provided to the patient during the consultation.