Both are established ways of treating a narrowing in the carotid artery. For a narrowing that has caused symptoms, surgery (endarterectomy) is considered first in many patients; for patients whose surgical risk is high or whose neck anatomy is not suitable for surgery, a stent is an option. The decision is made together by cardiology, neurology and vascular surgery, based on your symptoms, age, the structure of the narrowing and your general health.

Am I awake during the procedure?

Yes. The procedure is usually done with local anaesthetic to numb the access site, and you stay awake. This allows the team to monitor your brain function throughout by talking to you and asking you to squeeze a small object or someone's hand. You may feel a brief warmth in the head or face when the dye is given.

Does the stent remove the risk of stroke completely?

No. The aim is to reduce the risk of stroke coming from the narrowed carotid artery. Because stroke can have other causes too, taking your blood-thinning and cholesterol-lowering medicines regularly, controlling blood pressure and blood sugar, stopping smoking and regular check-ups all continue after the procedure.

In case of sudden chest pain, shortness of breath or fainting, call 112.

Stenting for carotid artery narrowing

A narrowing in the carotid artery, which carries blood to the brain, is opened with a stent placed through a thin catheter passed along the artery. The aim is to reduce the risk of stroke; it is one of the treatment options considered alongside surgery.

What is it?

The carotid arteries are the main arteries on each side of the neck that carry blood to the brain. Over time, a build-up of fat and calcium (plaque) can form in the artery wall and narrow the artery. Small pieces that break off the plaque, or a clot that forms on it, can travel with the blood flow to the brain and cause a mini-stroke (transient ischaemic attack) or a stroke. A mini-stroke, or a brief loss of vision in one eye, is a warning sign whose symptoms clear up quickly, and it needs to be assessed without delay. The foundation of treatment for everyone is medication and control of risk factors: cholesterol-lowering medicines, anti-clotting medicine for most people, blood pressure and blood sugar control, stopping smoking and regular activity. In some patients the artery is also opened: either the plaque is removed through an operation on the neck (carotid endarterectomy), or a stent (a thin metal mesh tube) is placed in the narrowing using a catheter passed along the artery. This page describes the stent procedure. Prof. Dr. Barış Kılıçaslan performs carotid artery stenting in his clinical practice.

Who is it for?

Patients who have recently had a mini-stroke (transient ischaemic attack) or a stroke and have a significant narrowing in the carotid artery
Among them, stenting is an option for patients whose surgical risk is high or whose neck anatomy is not suitable for surgery (for example, after previous radiotherapy to the neck, or when the narrowing is in a place that is hard to reach by surgery)
For a narrowing that causes no symptoms, opening the artery is considered only in selected patients; the main approach is medication and control of risk factors. The decision is made together with neurology and vascular surgery, taking into account your symptoms, imaging findings and general health

Before the procedure

Before the procedure, the degree of narrowing is assessed with a Doppler ultrasound of the neck. A CT or MR angiogram is done to see in detail the course of the arteries, starting from the curved part of the main artery leaving the heart (the aortic arch), and the structure of the plaque. Any previous mini-stroke or stroke symptoms are assessed with a neurological examination; brain imaging may also be done if needed. Before the procedure, two different blood-thinning (anti-clotting) medicines are started to help prevent clots forming on the stent; you continue taking them together after the procedure for as long as your doctor recommends. Your kidney function is checked with a blood test. Tell your doctor beforehand if you have ever had an allergy to contrast dye or if you have kidney disease. Your medications are reviewed with your doctor; do not stop any medication on your own.

How is it done?

Access site: The access site, usually the groin and in some cases the wrist, is cleaned and numbed with local anaesthetic. A thin sheath is placed in the artery, and a catheter is advanced through it up to the carotid artery. Dye is injected to show the narrowing; you may feel a brief warmth in the head or face as it is given.
Embolic protection: Usually, a protection method is used before the stent is placed, to reduce the chance of small pieces that may break off the plaque during the procedure reaching the brain. This can be a small filter opened beyond the narrowing, or temporarily stopping or reversing blood flow in the artery for the duration of the procedure. The method is chosen according to the structure of the artery.
Balloon and stent: If needed, the narrowing is widened with a small balloon, and a stent is placed to keep the artery open. While the balloon is inflated and the stent is opened, your heart rate and blood pressure may drop briefly; the team watches for this and corrects it with medicine if needed. Because you are awake, the team asks you from time to time to speak and to squeeze a small object or someone's hand; this way your brain function is monitored throughout the procedure.
Check and closure: The stent and the blood flow to the brain are checked with dye imaging. Any protection device used is removed, the catheters are withdrawn, and the access site is closed with pressure, a pressure band or a closure device.

Recovery

After the procedure you usually stay in hospital for one night for monitoring. During this time your blood pressure, heart rate, access site and neurological status (speech, arm and leg strength) are checked regularly. If the groin was used, you may be asked to lie flat without bending your leg for a few hours. It is very important to take both blood-thinning medicines together, without missing doses, for as long as your doctor recommends; after that, treatment continues long term with a single medicine. Keeping blood pressure and cholesterol under control, stopping smoking and regular activity remain a key part of treatment after the procedure. The stent is checked regularly with a Doppler ultrasound of the neck, the first time within the first month after the procedure. Call 112 if you have growing swelling or bleeding at the access site, sudden weakness in an arm or leg, difficulty speaking, a drooping face, sudden loss of vision or a sudden severe headache.

Risks

Like every interventional procedure, carotid stenting has risks. The most important is stroke: during the procedure or in the following days, small pieces that break off the plaque, or a clot, can travel to the brain and cause a stroke. The embolic protection method and the two blood-thinning medicines are aimed at reducing this risk; the neurological monitoring during the procedure means that any problem is noticed straight away. The level of risk varies from person to person, depending on age, the structure of the artery and general health. During the procedure and in the hours afterwards, heart rate and blood pressure can drop temporarily; this is monitored and corrected with medicine if needed. Rarely, the increased blood flow to the brain after the artery is opened can cause a severe headache or a seizure; good blood pressure control lowers this risk, which is why your blood pressure is monitored closely after the procedure. Bleeding, bruising or injury to the artery at the access site, an allergic reaction to the contrast dye and a decline in kidney function can also occur. Over time, the artery can narrow again inside the stent; this is why follow-up Doppler scans are done. Your possible benefits and risks are explained in detail by your doctor, according to your personal situation, at the consultation before the procedure.

Frequently asked questions

Surgery or a stent? Both are established ways of treating a narrowing in the carotid artery. For a narrowing that has caused symptoms, surgery (endarterectomy) is considered first in many patients; for patients whose surgical risk is high or whose neck anatomy is not suitable for surgery, a stent is an option. The decision is made together by cardiology, neurology and vascular surgery, based on your symptoms, age, the structure of the narrowing and your general health.
Am I awake during the procedure? Yes. The procedure is usually done with local anaesthetic to numb the access site, and you stay awake. This allows the team to monitor your brain function throughout by talking to you and asking you to squeeze a small object or someone's hand. You may feel a brief warmth in the head or face when the dye is given.
Does the stent remove the risk of stroke completely? No. The aim is to reduce the risk of stroke coming from the narrowed carotid artery. Because stroke can have other causes too, taking your blood-thinning and cholesterol-lowering medicines regularly, controlling blood pressure and blood sugar, stopping smoking and regular check-ups all continue after the procedure.

Medical content reviewed and approved by Prof. Dr. Barış Kılıçaslan. Last updated: 4 October 2026. Editor: Baran Zeydan (info@clinixcrm.app).