PERIPHERAL VASCULAR PROCEDURES << BACK Carotid Stenting Carotid artery stenting is a procedure in which a slender, metal-mesh tube, called a stent, is inserted to expand inside the carotid artery to increase blood flow in areas blocked by plaque on the walls of the artery. The carotid arteries supply blood to the brain, and are found on each side of the neck, extending from the aorta to the base of the skull. Blockages in the carotid arteries can cause a stroke. Carotid stenting is an alternative to carotid endarterectomy, which involves surgical removal of plaque. Patients are given a local anesthetic, and perhaps blood thinners, prior to the procedure. The physician locates the narrow areas in the arteries by injecting a dye into the arteries and using fluoroscopy, or real-time X-rays. Before inserting the stent, the physician will usually perform angioplasty, during which a long, thin tube called a catheter with an attached balloon is inserted into a small incision in the arm or groin. The physician guides the catheter to the blockage site in the carotid artery. Then a small balloon, basket, or filter called an embolic protection device, is inserted to prevent strokes by catching the debris that may break away from the plaque during the procedure. The physician then inserts a stent into the carotid artery to hold the artery open. The most serious risk to carotid stenting is an embolism, or blockage by a clot or other debris in an artery in your brain. This blockage can cause a stroke. Other complications that may cause a stroke include a blood clot forming along the stent or a tear in the artery wall. The re-blockage of the carotid artery, called restenosis, is another possible complication. In rare cases, patients react to the dye used during the angiogram.