Carotid and vertebral artery stenting are pin-hole procedures used to open narrowed arteries of the neck that supply blood to the brain. By placing a small metal mesh tube (stent) inside the artery, we improve blood flow and reduce the risk of future stroke.
What is Carotid & Vertebral Artery Stenting?
The carotid arteries run along each side of the front of the neck, and the vertebral arteries run up the back of the neck. As we age, fatty deposits called plaque can build up inside these arteries, narrowing them — a condition known as stenosis. When an artery is significantly narrowed, less blood reaches the brain, which can lead to stroke or stroke-like symptoms.
Stenting is a minimally-invasive procedure in which a thin tube (catheter) is inserted through a small puncture — usually in the groin — and guided to the narrowed artery using X-ray imaging. A tiny mesh tube (stent) is then placed inside the artery to hold it open and restore normal blood flow.
This is often done under local anesthesia with light sedation, and most people go home within 1–2 days.
Symptoms
Many people with carotid or vertebral artery narrowing have no symptoms until a stroke or "mini-stroke" (TIA) occurs. Warning signs may include:
- Sudden weakness or numbness on one side of the face, arm, or leg
- Sudden trouble speaking or understanding speech
- Sudden vision changes or blurring in one or both eyes
- Sudden dizziness, loss of balance, or coordination problems
- Sudden, severe headache with no known cause
Causes & Risk Factors
- High blood pressure (hypertension)
- High cholesterol
- Diabetes
- Smoking
- Obesity and physical inactivity
- Family history of stroke or heart disease
- Older age
When to See a Doctor
Seek immediate medical attention if you experience any of the above symptoms or stroke-like symptoms — even if they go away quickly. Talk to your doctor if you have risk factors for vascular disease or have been told you have a "blocked artery in the neck."
Diagnosis
- Physical exam & medical history — listening for abnormal blood-flow sounds (bruits) in the neck.
- Carotid ultrasound (Doppler) — measures blood flow and narrowing in the carotid arteries.
- CT angiography (CTA) or MR angiography (MRA) — detailed imaging of the arteries.
- Catheter angiography (DSA) — the gold-standard test used during the procedure to precisely map the narrowing.
Treatment / Procedure
Not everyone with narrowing needs a stent. Treatment depends on how severe the narrowing is and whether symptoms are present.
Medical Management (for all patients)
- Blood pressure & cholesterol control
- Diabetes management
- Antiplatelet medicines (e.g. aspirin, clopidogrel)
- Lifestyle changes: quitting smoking, healthy diet, exercise
Procedural Options
Carotid Artery Stenting (CAS)
Minimally-invasive stent placement via a groin puncture, often with a protective filter to catch any debris.
Vertebral Artery Stenting
A similar stenting technique for the vertebral arteries — often preferred because surgery is rarely feasible in this location.
After the procedure, patients typically take dual antiplatelet therapy (aspirin plus another agent) for several weeks to months, followed by long-term single antiplatelet therapy.
Conclusion
Carotid and vertebral artery stenting are safe, effective, minimally-invasive options to restore blood flow and reduce stroke risk in people with significant arterial narrowing. While not everyone needs a stent, timely evaluation and treatment — combined with strong risk-factor control — can prevent devastating strokes and improve long-term brain health.