Carotid endarterectomy is themain treatment for narrowing of the carotid arteries as it'svery effective.
However, there's also an alternative procedure called carotid artery stent placement, or "stenting".
Carotid artery stent placement is less invasive than a carotid endarterectomy becauseit doesn't involve a cut being madein the neck.
Stenting is carried out under local anaesthetic and involvesa narrow flexible tube called a catheter being inserted intoan artery in your groin. It's thenthreaded up into the carotid artery using X-rays to guide it into place.
A small balloonat the end of the catheter is inflated to around 5mm at the site of the narrowed artery, and a small mesh cylinder called a stent is theninserted. The balloon will be deflated and removed, leaving the stent in place to keep the artery openand allow blood to flow through it.
After the procedure, you'll need to lie flat and keep still for about an hour to prevent any bleeding from the artery. You'll 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 risk of having another stroke or dyingis slightly higher than after carotid endarterectomy, especially when the procedure isperformed soon after symptoms appear. Butthe long-term outcomes from a successful procedureare no differentfrom acarotid endarterectomy.
The decision about which procedure you'll have will be made based on your own personal wishes, your overall fitness, and an assessment of your clinical history. One major factor is how long it's been since your most recent symptom.
The National Institute for Health and Care Excellence (NICE)has confirmed stenting is a safe procedure and hasgood short-term results.
Evidence suggests a successful stent procedure has the same long-term risks of a stroke as carotid endarterectomy.
NICE advises that, provided the risksof stenting are judgedsimilar to those after surgery, it's safe to offer this alternative.
Read the NICE guidance on carotid artery stent replacement for symptomatic extracranial carotid stenosis .
A carotid endarterectomy is a surgical procedure to unblock a carotid artery. The carotid arteries are the main blood vessels that supply the head and neck.
A carotid endarterectomy may be needed if one or both of your carotid arteries becomes narrowed by a build-up of fatty deposits (plaque).
Before having a carotid endarterectomy, you'll attend a pre-admission clinic where you'll have a physical examination and be asked about your medical history.
A carotid endarterectomy will either be carried out under general or local anaesthesia.
After a carotid endarterectomy, you will usually be moved to the recovery area of the operating theatre or, in some cases, a high dependency unit (HDU).
As with all types of surgery, there are some risks associated with having a carotid endarterectomy.
A carotid endarterectomy is the main treatment for narrowed carotid arteries. However, an alternative procedure called carotid artery stent placement can also be used.
Mr Joseph Leverment, from Cropston, Leicester, had a carotid endarterectomy while he was a senior surgeon at University Hospitals of Leicester NHS Trust.