Carotid Artery Stenting

Carotid artery stenting widens a narrowed carotid artery from the inside. A catheter is passed from the groin, wrist or a small cut at the base of the neck, the narrowing is crossed, and a self-expanding metal mesh stent is released to hold the artery open and trap the plaque against the wall.

Like carotid surgery it aims to prevent stroke rather than treat one. It avoids a neck incision and nerve injury, but in trials it carried a somewhat higher risk of stroke during the procedure than surgery, particularly in people over 70.

What Carotid Artery Stenting involves

You start aspirin and a second antiplatelet such as clopidogrel several days beforehand. Under local anaesthesia a sheath is placed in the femoral artery and a long catheter is guided to the carotid artery under X-ray, with heparin running. A protection device is set up first: either a tiny filter basket opened beyond the narrowing to catch debris, or a system that temporarily stops or reverses flow. The narrowing may be pre-stretched with a small balloon, the stent is positioned across it and released, and a second balloon expands it fully. Stretching the artery can briefly slow the heart, so atropine is kept ready. The filter is retrieved, final pictures are taken and the puncture is sealed.

Who is a good candidate for Carotid Artery Stenting?

Chosen mainly when open surgery would be unusually risky or technically difficult.

• Significant symptomatic narrowing with previous neck radiotherapy or radical neck surgery
• Re-narrowing after an earlier endarterectomy
• A lesion too high or too low to reach safely through the neck
• A tracheostomy, or paralysis of the opposite vocal cord
• Serious heart or lung disease that makes anaesthesia and surgery hazardous
• Generally, patients under 70 with suitable arch anatomy

It is usually not the right choice if:

• Most patients over 70 to 75 with an ordinary neck, for whom surgery is usually safer
• A heavily calcified, very tortuous or thrombus-laden artery, or a difficult aortic arch
• Inability to take two antiplatelet drugs for at least a month
• Severe kidney impairment, because contrast dye is needed
• A completely blocked artery

Technique options

• Transfemoral stenting with a distal filter: The traditional route from the groin.
• Proximal protection with flow arrest: Stops flow before the lesion is crossed; used for unstable-looking plaque.
• Transcarotid revascularisation (TCAR): A small cut above the collarbone with blood flow reversed during stenting, avoiding the aortic arch; lower stroke rates in registries.
• Dual-layer mesh stents: A finer inner mesh designed to hold plaque fragments more securely.
• Radial access: From the wrist, in selected anatomy.

What happens during your treatment

The procedure takes 45 to 90 minutes under local anaesthesia with light sedation, so you can speak and squeeze a toy on request for neurological checks. You may feel a brief warm flush with dye and a moment of light-headedness when the balloon inflates. You lie flat for a few hours afterwards and stay 1 night for blood pressure monitoring.

Preparing for your trip

A single session. Allow 5 to 7 days in Istanbul: imaging and antiplatelet loading for the first days, the procedure, one night in hospital and a duplex check before flying. Follow-up scans can then be done at home.

• Tell the doctor about medication, allergies, pregnancy or breastfeeding, and any history of cold sores, keloid scars or autoimmune disease
• Avoid alcohol, aspirin and anti-inflammatory painkillers for a few days beforehand if your own doctor agrees, to reduce bruising
• Arrive without make-up on the treatment area and avoid sunbeds and strong sun for two weeks before

Recovery and results

Most people resume normal activity within a few days, avoiding heavy lifting for a week to protect the groin. Two antiplatelet drugs are taken for 1 to 3 months and then one for life, with a statin. Low blood pressure or a slow pulse can persist for a day or two. Duplex ultrasound is repeated at 1, 6 and 12 months and then yearly.

• Back to everyday activity: 2 to 5 days
• When results show: Stroke risk reduction is immediate
• How long they last: Long-lasting; re-narrowing in about 5 to 10 percent

Safety, risks and revision policy

The main risk is stroke caused by debris dislodged during the procedure.

• Stroke or death around the procedure, roughly 3 to 7 percent in symptomatic patients depending on age and anatomy
• Slow heart rate and low blood pressure from stretching of the carotid sinus
• Heart attack, less often than with surgery
• Bleeding, haematoma or false aneurysm at the access site
• Hyperperfusion syndrome with headache, seizure or brain bleed
• Contrast-related kidney injury or allergy
• Re-narrowing or clotting within the stent
• Bleeding elsewhere from dual antiplatelet treatment

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Carotid Artery Stenting in Türkiye

Clinic-Y does not publish a single price for Carotid Artery Stenting, because the honest figure depends on your case. What moves it:

• Stent and embolic protection devices, which are single use
• Transfemoral versus TCAR approach
• Angiography suite time and one night of monitored care
• CT or MR angiography and duplex before and after

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions