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Patient Instructions

You had an angioplasty done when you were in the hospital. You may have also had a stent (a tiny tube) placed in the blocked area to keep it open. Both of these were done to open a narrowed or blocked artery that supplies blood to your brain.

Your surgeon inserted a catheter (flexible tube) into an artery through an incision (cut) in your groin. Your surgeon used live x-rays to carefully guide the catheter up to the area of the blockage in your carotid artery. Then your surgeon passed a guide wire through the catheter to the blockage. A balloon catheter was pushed over the guide wire and into the blockage. The balloon on the end was blown up. This opened the blocked artery.

You should be able to do most of your normal activities within a few days, but take it easy.

If your surgeon put the catheter in through your groin:

• Walking short distances on a flat surface is okay. Limit going up and down stairs to about 2 times a day for the first 2 to 3 days.
• Do NOT do yard work, drive, or play sports for at least 2 days, or for the number of days your doctor tells you to wait.

You will need to care for your incision.

• Your doctor or nurse will tell you how often to change your dressing (bandage).
• If your incision bleeds or swells up, lie down and put pressure on it for 30 minutes. If the bleeding or swelling does not stop or gets worse, call your doctor and return to the hospital, or go to the closest emergency room. Or, call 911.

Having carotid artery surgery does not cure the cause of the blockage in your arteries. Your arteries may become narrow again. To lower your chances of this happening:

• Eat a heart-healthy diet, exercise, stop smoking (if you smoke), and reduce your stress level.
• Take medicine to help lower your cholesterol if your doctor prescribes it. See also: Cholesterol - drug treatment
• If you are taking medicines for blood pressure or diabetes, take them the way your doctor has asked you to.

Your doctor may recommend that you take aspirin or another medicine called clopidogrel (Plavix) when you go home. These medicines keep blood clots from forming in your arteries and in the stent. Do NOT stop taking them without talking with your doctor first.

See also:

• Clopidogrel (Plavix)
• Aspirin and your heart

Call your doctor or nurse if:

• You have a headache, become confused, or have numbness or weakness in any part of your body.
• You have problems with your eyesight or you cannot talk normally.
• There is bleeding at the catheter insertion site that does not stop when pressure is applied.
• There is swelling at the catheter site.
• Your leg or arm below where the catheter was inserted changes color or becomes cool to touch, pale, or numb.
• The small incision from your catheter becomes red or painful, or yellow or green discharge is draining from it.
• Your legs are swelling.
• You have chest pain or shortness of breath that does not go away with rest.
• You have dizziness, fainting, or you are very tired.
• You are coughing up blood or yellow or green mucus.
• You have chills or a fever over 101 °F.

Carotid angioplasty and stenting - discharge; CAS - discharge; Endarterectomy - carotid artery - discharge; Angioplasty - carotid artery - discharge; Percutaneous transluminal angioplasty - carotid artery - discharge; PTA - carotid artery - discharge; Angioplasty - carotid artery - discharge

Goldstein LB. Prevention and management of stroke. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders;2007:chap 58.

Mas JL, Chatellier G, Beyssen B, Branchereau A, Moulin T, Becquemin JP, et al. Endarterectomy versus stenting in patients with symptomatic severe carotidstenosis. N Engl J Med. 2006 Oct 19;355(16):1660-71.

Eckstein HH, Ringleb P, Allenberg JR, et al. Results of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) study to treat symptomatic stenoses at 2 years: a multinational, prospective, randomised trial. Lancet Neurol. 2008 Oct;7(10):893-902. Epub 2008 Sep 5.

Updated by: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA.. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.