Angioplasty and stent placement - carotid artery - discharge

When You Were in the Hospital

You had an angioplasty done when you were in the hospital. You may have also had a stent (a tiny wire mesh 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 health care provider inserted a catheter (flexible tube) into an artery through an incision (cut) in your groin or your arm.

Your health care provider used live x-rays to carefully guide the catheter up to the area of the blockage in your carotid artery.

Then your health care provider passed a guide wire through the catheter to the blockage. A balloon catheter was pushed over the guide wire and into the blockage. The tiny balloon on the end was inflated. This opened the blocked artery.

What Expect at Home

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

Self-care

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, 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 right away. If bleeding or swelling are severe even before 30 minutes have passed, call 911 right away. Do not delay.

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 healthy foods, exercise (if your doctor advises you to), stop smoking (if you smoke), and reduce your stress level.
• Take medicine to help lower your cholesterol if your doctor prescribes it.
• If you are taking medicines for blood pressure or diabetes, take them the way your doctor has asked you to.
• Your doctor may ask you to take aspirin and/or another medicine called clopidogrel (Plavix), or another medicine, when you go home. These medicines keep your blood from forming clots in your arteries and in the stent. Do not stop taking them without talking with your doctor first.

When to Call the Doctor

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.

References

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease. J. Am. Coll. Cardiol. 2011;124:e54-e130.

Eisenhauer AC, White CJ, Bhatt DL. Endovascular treatment of noncoronary obstructive vascular disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Elsevier Saunders; 2011:chap 63.

Silva MB Jr., Choi L, Cheng CC. Peripheral arterial occlusive disease. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 19th ed. Elsevier Saunders; 2012: chap 63.

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