Carotid angioplasty and stenting

The carotid arteries, on each side of the neck, supply blood to the brain. An atheroma plaque can narrow them and release small fragments that cause a stroke. Carotid angioplasty involves placing a stent inside the artery that presses the plaque against the wall and restores a good diameter. The procedure is performed in the catheterisation laboratory under local anaesthesia, which allows the team to check continuously that the patient can speak and move normally. The catheter is introduced in the groin or at the wrist and advanced up to the neck. A protection system (a small filter or temporary flow blockage) is generally used to stop debris from travelling to the brain. Open surgery (endarterectomy) often remains the standard treatment for carotid narrowing. Stenting is offered in specific situations: a neck that has already been operated on or irradiated, a lesion that is difficult to reach, or a patient at high surgical risk. The decision is made jointly by the neurologist, the vascular surgeon and the interventional physician. At Clinique Pasteur Tunis, the procedure is performed in a latest-generation catheterisation laboratory, with close neurological and cardiac monitoring afterwards.