Carotid Stenting

The carotid arteries supply blood to the brain and are located on each side of the neck. If the carotid artery becomes blocked or narrowed (stenosis) then there is a reduction of blood supply to the brain and this could result in a stroke. A carotid stent is a metal mesh tube that is inserted to prop open the inside of vessel.

Carotid angioplasty stenting can be performed due to:

• Cerebral Vascular Accident (CVA) / Transient Ischemic Attach (TIA)
• Peripheral weakness
• when surgery (carotid endarterectomy) is not an option
• Carotid stenosis 

A staff member will provide you with the appropriate individual instructions upon booking your appointment.  This procedure will require general anaesthetic therefore you will need to fast from midnight the night before your appointment. This will ensure that your stomach is empty and eliminate the risk of aspiration (food or fluid in the lungs).

Please inform the clerk at the time of booking your procedure if you are currently taking medication that thins your blood (eg Aspirin, Plavix, Warfarin)  as these may need to be stopped a few days prior to your procedure. It may be useful to bring a LIST of medications to your appointment.

You will need to have a blood test a few days prior to your appointment to assess your kidney function and blood clotting times. If your blood sample was taken outside the hospital then please obtain a copy of the results and bring it with you on the day of your procedure.

You will need to bring any previous films (x-ray/CT/MRI/US) along to your appointment.

It is important that you inform a member of staff as soon as possible if you are pregnant BEFORE the procedure is performed. If you suspect that you could be pregnant then you will need to have a pregnancy test at the hospital prior to the commencement of the procedure.

This procedure involves the use of intravenous contrast; see Intravenous Contrast

For health and safety reasons, family members cannot be present with you during the procedure. A staff member will be available to assist you at all times during the procedure if you have any concerns.

A doctor will explain the procedure beforehand and you will be required to sign a consent form. If you require an interpreter, please inform the booking clerk at the time of booking.

This procedure requires your groin area to be shaved. It is optional if you wish to personally attend to this prior to your appointment.

You will be asked to remove underwear and change into a hospital gown. All jewellery and metal objects in the area to be scanned will need to be removed as this can cause artefact and obscure the images.

Yow will be seen by an anaesthetist who will be happy to provide information and answer your questions about the general anaesthetic.

You will be positioned on your back on the procedure table.  An IV cannula will be inserted into a vein in your arm. The anaesthetist will then administer the medications to put you to sleep.

When you are asleep, a cold cleaning solution will be applied to clean the skin in your groin area and a sterile sheet will be draped over your body with part of the groin exposed.

A needle will be inserted using ultrasound guidance into the common femoral artery in your groin. A soft wire is inserted through the needle into your artery and the needle is then replaced with a short plastic tube called a sheath. A catheter is then guided through your arteries and carefully advanced to the carotid artery in your neck.

Once the catheter is in place, a special contrast material goes through the catheter. X-ray images are taken to see how the contrast moves through the artery. The contrast helps highlight any blockages in blood flow. Once the blockage is located a stent (small metal mesh tube) is deployed to open the artery.

At the end of the procedure the sheath will be removed and pressure is immediately applied to the area for about 10 to 15 minute to stop bleeding.

You will then be woken up and will need to remain lying flat for up to four hours. Your groin and vital signs will be monitored regularly post procedure for haematoma, oozing and bruising. 

You will need to stay in hospital overnight.

Staff will discuss with you what level of activity is suitable after your procedure. You should monitor the groin (insertion site) for bleeding for the next 12 hours.

Go to your nearest Emergency Department or GP if you become unwell or have:

• A cool or cold limb
• Slurred speech, balance problems or trouble using your arm or leg
• Pain unrelieved by over-the-counter pain killers
• Continuous bleeding or swelling at the puncture site
• Signs of infection such as redness, inflammation at the puncture site or fever

A report regarding your procedure will be given to you before you leave to give to your referring doctor. It contains information about your procedure and any findings that your doctor should know about.

• Fasted (no food or drink) for four hours
  
  
• Recent Blood test
  
  
• Removed all Jewellery and metal objects

Don't forget to bring these along to your appointment

• Referral/request form from your doctor
  
  
• Medicare / Pension card
  
  
• Previous films and report