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When your doctor tells you about a blockage in your carotid artery, it can feel overwhelming. You’re probably wondering about the next steps. Two main treatments come up in these conversations: carotid endarterectomy (surgery) and carotid stenting. Both get the job done, but they work differently.
Here’s the thing: there’s no one-size-fits-all answer. Your age, health and how bad the blockage is all matter when picking the right treatment.
How These Treatments Work
Your carotid arteries are like highways bringing blood to your brain. When plaque builds up and blocks these arteries, you’re at risk for a stroke. Both treatments clear the blockage, just in different ways.
Treating carotid artery disease involves choosing the right approach based on your specific situation. Here’s how each option works:
Carotid Endarterectomy (Surgery)
Your surgeon makes a small cut in your neck, opens up the artery and removes the plaque. Then they close everything back up, sometimes with a patch to keep the artery wide open.
Carotid Stenting
This is less invasive. Your doctor inserts a thin tube through an artery in your groin and guides it up to your neck. They place a small mesh tube (stent) in the blocked area. The stent pushes the plaque aside and stays there to keep blood flowing.
What Recovery Looks Like
Recovery is pretty different for each option.
Surgery recovery:
- Hospital stay: A few days
- Back to normal: About two weeks
- You’ll have a neck scar
- Need to rest up initially
Stenting recovery:
- Hospital stay: Usually go home next day
- Back to normal: Within a week
- No visible scar
- Must lie still for a few hours after the procedure
When Surgery Is Your Best Option
You’ve had stroke symptoms
Studies show surgery works better if you’ve already experienced a mini-stroke or stroke warning signs. It lowers your chances of having another stroke in the months after treatment.
Your blockage is complicated
Some blockages are tricky. If yours has heavy calcium buildup or sits in an unusual location, your surgeon can handle it better with direct access through surgery.
You’re healthy enough for surgery
If your heart is in good shape and you can safely handle anesthesia, surgery usually delivers better long-term results.
When Stenting Is the Better Choice
Surgery is too risky for you
Some people have heart or lung problems that make surgery risky. If you’re dealing with other vascular issues, such as PAD or you’ve had neck surgery or radiation before, stenting is often safer.
The blockage is hard to reach
If your blockage sits high up in your neck or behind your jawbone, it’s tough for a surgeon to get to. Stenting works well for these spots.
You’re younger and symptom-free
Studies show people under 70 do just as well with stenting, especially if they haven’t had stroke symptoms yet. Plus, the faster recovery helps if you need to get back to work or take care of your family.
The Success Rates
Both treatments work well at preventing strokes. Here’s what the research shows:
Long-term results:
- Stenting: 7% stroke or death rate over 4 years
- Surgery: 5% stroke or death rate over 4 years
First month risks:
- Stenting has higher stroke risk during procedure (4% vs 2%)
- Surgery has higher heart attack risk during recovery (2.3% vs 1.1%)
- After the first few weeks, both protect you equally well
What Your Doctor Will Consider
When recommending a treatment, your vascular surgeon looks at:
- Your symptoms: If you’ve had stroke symptoms, surgery usually works better. No symptoms? You’ve got more options.
- Your age: People over 70 tend to do better with surgery. Younger folks see similar results with both.
- Your health: Heart disease, past neck surgery, or radiation treatment might point toward stenting.
- Your blockage: Where it sits, how bad it is and whether there’s calcium buildup all matter.
What Happens During Your Procedure
Both treatments need close monitoring. During surgery, your team watches your brain’s blood flow the whole time. With stenting, doctors use a tiny filter to catch any loose particles. New techniques in TCAR Surgery have made stenting even safer by going through your neck instead of your groin.
Questions to Ask Your Doctor
Find out why your doctor suggests one treatment over the other. Ask how many times they’ve done each procedure (experience matters a lot). And make sure you understand the specific risks for your situation.
After Your Treatment
No matter which treatment you get, you’ll need to manage your risk factors. Both fix the blockage, but they don’t cure what caused it.
You’ll take blood thinners and cholesterol meds. Keeping your blood pressure under control becomes even more important. Lifestyle changes like quitting smoking, eating healthier and staying active all help protect you long-term.
You’ll also need regular ultrasounds to make sure everything’s working right. Getting carotid artery screening early can catch issues before they get serious.
So Which One Should You Choose?
Here’s the truth: neither option is automatically better. It depends on your age, health and what’s going on with your arteries.
What matters most is finding a vascular specialist who knows what they’re doing and can explain your options clearly. Don’t be afraid to ask questions or get a second opinion.
At Prime Vascular Care we’ll help you understand your options and figure out the best treatment for your situation. Just get in touch with us to get more details.
