Carotid Endarterectomy vs. Stenting – What’s Right for You?

Common Questions From Patients

• What is carotid endarterectomy?
• How does carotid stenting work?
• Which is safer: carotid surgery or stenting?
• What are the risks and benefits of carotid artery procedures?
• How to prevent stroke with carotid artery treatment?

If these questions are on your mind after a carotid artery narrowing diagnosis, this guide will help you understand the two main treatment options and decide which might suit you best.

What Is Carotid Artery Disease?

Carotid artery disease occurs when the major arteries supplying blood to the brain become narrowed or blocked by atherosclerosis (fatty plaque buildup). This increases the risk of ischemic stroke—the most common type of stroke caused by blocked blood flow.

Why Treat Carotid Artery Narrowing?

Narrowed carotid arteries can cause:

• Transient ischemic attacks (TIAs or “mini-strokes”)
• Full-blown ischemic strokes
• Sudden weakness, speech difficulty, or vision loss

Treatment is critical to reduce stroke risk and improve long-term brain health.

What Are the Two Main Treatment Options?

1. Carotid Endarterectomy (CEA)
2. Carotid Artery Stenting (CAS)

Both procedures aim to restore normal blood flow but differ in how they are performed.

Carotid Endarterectomy (CEA)

What is it?
CEA is an open surgical procedure where the neurosurgeon makes a small incision in the neck to expose the carotid artery. The surgeon then removes the fatty plaque causing the blockage.

Who is it for?

• Patients with significant carotid narrowing (usually >70%)
• Those fit for surgery without high-risk heart or lung problems

Benefits:

• Long history of proven effectiveness
• Low rates of recurrent narrowing
• Usually preferred for symptomatic patients

Risks:

• Risk of stroke or heart attack during surgery (rare)
• Nerve injury causing hoarseness or swallowing difficulty (usually temporary)
• Bleeding or infection

Carotid Artery Stenting (CAS)

What is it?
CAS is a minimally invasive endovascular procedure performed through a catheter inserted in the groin or wrist. A stent—a tiny mesh tube—is placed inside the narrowed artery to widen it and keep it open.

Who is it for?

• Patients with medical conditions making surgery risky
• Those with prior neck surgery or radiation
• Patients who prefer less invasive options

Benefits:

• No neck incision
• Shorter hospital stay and recovery time
• Suitable for patients with significant surgical risks

Risks:

• Slightly higher risk of stroke during procedure compared to CEA
• Potential for restenosis (re-narrowing)
• Requires lifelong antiplatelet therapy (blood thinners)

Carotid Endarterectomy vs. Stenting — Which Is Better?

Dr. Naba J. Borah’s Expertise

Dr. Borah, with over 10,000+ neurosurgeries, is highly experienced in both carotid endarterectomy and carotid stenting. He tailors treatment plans based on each patient’s health, artery condition, and preferences, ensuring the safest and most effective outcomes.

Where to Get Treatment?

At Health City Hospital, Guwahati, Dr. Borah provides:

• Advanced neurovascular imaging
• Multidisciplinary stroke and vascular team
• 24/7 neurocritical care support
• Personalized post-procedure rehabilitation

Recovery and Aftercare

• Medications: blood thinners and cholesterol control drugs
• Lifestyle changes: diet, exercise, smoking cessation
• Regular follow-up with ultrasound or angiography
• Monitoring for symptoms of stroke or restenosis

Related Reads:

• Cerebral Angioplasty: A Minimally Invasive Solution for Blocked Brain Arteries
• Stroke vs. Brain Hemorrhage: Know the Difference and When to Act Fast

Final Thoughts

Choosing between carotid endarterectomy and stenting is a crucial decision. Understanding the benefits and risks of each helps you make an informed choice. Consult a neurosurgeon like Dr. Naba J. Borah to determine the best treatment tailored to your condition.