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Treatment / Carotid Stenting and Revascularization

Carotid artery stenosis is a narrowing of the larger arteries on either side of the neck that carry blood to the head, face and brain. This narrowing is usually the result of a build-up of plaque within the arteries, a condition called atherosclerosis. Stenosis can worsen over time to completely block the artery which may lead to a stroke.

Am I a Candidate for Treatment?

Treatment options for carotid artery disease depend upon the severity of the overall patient condition and symptoms. Moderate disease may not require an interventional procedure. More severe blockages may require treatment with open surgery, called carotid endarterectomy, or an endovascular procedure in which a carotid stent is implanted to stabilize the plaque to prevent a future stroke. You should be screened for carotid artery disease if you have:

  • Weakness, numbness, tingling or paralysis of the arm, leg, or face on one side of your body
  • Trouble swallowing
  • Loss of eyesight or blurry eyesight in one eye
  • Dizziness, confusion, fainting , or coma
  • Unexplained slurred or garbled speech

Sometimes, patients are screened for carotid artery disease if the doctor knows the patient has vascular disease elsewhere in the body. Blockages can also be found when your physician hears a sound through a stethoscope placed on the neck. The sound is caused by blood flowing past the blockage.

Interventional Procedure

Carotid angioplasty and stenting

has been FDA-approved as a treatment option for some patients with carotid artery disease. In 2016, the New England Journal of Medicine reported that stenting and surgery are equally safe and effective at reducing stroke risk. Your doctor will determine if you are a candidate.

Carotid angioplasty and stenting procedure is performed while the patient is awake, but sedated. During the procedure, a balloon catheter is inserted through a sheath in a blood vessel. With x-ray guidance, the catheter is placed through the blood vessel and directed to the carotid artery at the site of the blockage or narrowing. A specially designed filter is placed beyond the area of the blockage or narrowing.

Once in place, the balloon is inflated for a few seconds to open or widen the artery. The filter (called the embolic protection device) collects any debris that may break off of the blockage. A stent (a small mesh tube) is placed in the artery and opens to fit the size of the artery and provide a framework to allow the artery to stay open. The stent stays in place permanently and acts as a scaffold to support the artery walls and keep the artery open. After several weeks, the artery heals around the stent.

During the procedure, a small incision is made at the base of the neck, just above the collarbone. A puncture is made into the carotid artery and a small tube is placed inside the artery. This gets connected to the system that will temporarily direct blood flow away from the brain. The blood is filtered and then returned to a vein through a second tube placed in the upper thigh. While the brain is protected during this temporary flow reversal, a stent is placed in the carotid artery to stabilize the plaque and prevent future stroke. The blood flow is then returned to normal and the system is removed.


Research has shown that carotid stenting, when used with the embolic protection device, was as safe and effective as carotid endarterectomy in high-risk surgical patients. Recovery from carotid angioplasty and stenting procedures generally requires a one-night hospital stay. Patients often return to regular activities within one to two weeks after these procedures.

If you have been diagnosed with carotid artery stenosis and are exploring your options for treatment, call IVC today at 503-612-0498 to schedule an appointment for consultation.

* This information about Carotid Stenting and Revascularization was reviewed by Dr. Jason R. Bauer. If you have any questions, please don’t hesitate to contact us using the form below.

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We are announcing that Interventional and Vascular Consultants will be closing as of March 10, 2023.

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Jason Bauer, MD RVT
Michael Pfister, MD RVT

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