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During the procedure, a long thin tube called a catheter is inserted into the artery. This is used to move instruments through the artery to put the stent in place. Your doctor will need to talk to you during the procedure, so you’ll be awake the entire time.
The skin in the area of the insertion site is first cleaned with an antiseptic solution, then numbed with local anesthetic. A puncture is made in the femoral artery, a major artery in the groin.
An introducer sheath (tube) is inserted into the puncture.
The catheter is inserted into the sheath. Using X-rays as a guide, the doctor moves the catheter through the sheat and up through the aorta, behind the heart, and to the carotid.
An angiogram of the carotid artery is taken. A contrast "dye" will be injected into a vein to show the location of the narrowed portion of the artery on X-ray. You may feel a warm sensation toward your head or the legs just after the dye is injected. Also, you may think that you see some flashing lights. This is normal and will only last for a few seconds. If it persists, let your doctor know immediately.
A filter or other protective device prevents pieces of plaque from being carried into the brain and causing a stroke. The catheter is used to place the unopened filter in the artery and advance it past the narrowed area. The filter is then opened. It remains in place for the whole procedure. If narrowing is very severe, the artery may need to be widened before the filter is put in place.
The narrowed artery will be opened up or expanded. This is done using balloon angioplasty.
A tiny uninflated balloon is first moved to the area that needs to be widened.
The balloon is then inflated, pushing the artery open. The balloon may need to be inflated and deflated several times to open the artery enough.
After the procedure is done, the balloon is deflated and removed.
The stent is moved to the site of the plaque.
The catheter is then withdrawn, leaving the stent in place.
The stent expands until it touches the plaque. Balloon angioplasty is then used to expand the stent fully and widen the artery. You may feel a slight pain in your neck during the baloon angioplasty.
The balloon is withdrawn, leaving the stent in place to hold the artery open.
An angiogram is taken and compared to the one that was taken at the beginning of the procedure. Once your doctor is satisfied with the result, the filter and other instruments are withdrawn. The groin insertion site is then closed.