What should I think about if I have carotid artery stenting?

The decision about whether to have carotid artery stenting, have carotid endarterectomy or take medicine is different for every person. It's important to talk to your doctor about your individual risks and your options.

Several things affect whether carotid artery stenting is more effective than treatment with medicine. One important factor is the skill of the surgeon. Research suggests that the surgeon doing the carotid artery stenting should have a low complication rate in order for the procedure to be considered beneficial for his or her patients. The American Heart Association recommends a complication rate less than 6% for carotid artery stenting. Complication rates higher than 6% negate the potential benefit of stroke risk reduction. In other words, if the surgeon's complication rate is higher than 6%, you are more likely to have complications from the surgery than to benefit from long-term reduction in your risk for stroke.

To find your surgeon's complication rate, check with his or her office, the hospital where the surgery will be done and your state's medical association. Access to this information may vary by state.

Another way to measure how much carotid artery stenting may reduce your risk of stroke compared to medicine is by looking at the experience of the hospital staff with this procedure. In general, larger hospitals and regional medical centers have staffs that are more experienced in doing carotid artery stenting than staffs in smaller hospitals. Check to see how many procedures are done in your hospital each year.

Other things that affect how successful carotid artery stenting may be are your age, gender, other health problems and how severe your first TIA or stroke was.