Carotid stents: is the gold standard ready for change?

Carotid angioplasty and stenting in carotid artery stenosis: neuroscience nursing implications

Stenosis of the internal carotid artery due to atherosclerosis can cause embolic stroke or cerebral ischemia, both of which may result in significant morbidity, mortality, and long-term disability. Although the endovascular technique with balloons and stents to relieve arterial (i.e., coronary) stenosis has allowed a nonsurgical approach to the management of atherosclerotic disease for many years, its use in carotid vessels has only recently gained popularity. In addition, improvements in endovascular access systems have extended the use of carotid angioplasty and stenting (CAS), especially since the advent of cerebral emboli protection devices. Nowadays, CAS is emerging as an intervention for high-risk surgical patients with high-grade carotid artery stenosis. Nursing care of these patients before, during, and after CAS is challenging. Patients and family need to be educated about the aim and consequences of the procedure and its complications. To care for these patients, the nurse must understand the techniques of CAS. The purpose of this article was briefly to review the etiology of stroke, the current treatments to relieve carotid stenosis, and the basic steps of CAS. The nursing management throughout the procedure, the patient preparation before the procedure, and most importantly, the postprocedure nursing care are discussed.