Carotid Artery Stenting in Delhi

Carotid artery stenting is a minimally invasive procedure that opens narrowed carotid arteries and restores blood flow to the brain. The carotid arteries run on either side of the neck and are among the most critical vessels in the body. They supply oxygen-rich blood directly to the brain. When fatty plaque accumulates inside these arteries, a condition called carotid artery stenosis, the narrowing restricts blood flow and raises the risk of stroke or transient ischaemic attack (TIA).

For patients where open surgery carries a higher risk, or where the blockage is not accessible through conventional techniques, carotid artery stenting offers a dependable, catheter-based option to treat the narrowing without any incision in the neck.

Dr. Dinesh Kumar Mittal, Senior Cardiac and CTVS Surgeon at Fortis Hospital, Shalimar Bagh, Delhi, provides specialist evaluation and endovascular management for carotid artery disease, applying catheter-based stenting techniques to reduce stroke risk and deliver the best realistic outcome for each patient’s specific condition.

What Is Carotid Artery Stenting?

Carotid artery stenting (CAS) is a procedure where a small metal mesh tube (stent) is placed inside a narrowed carotid artery to restore normal blood flow to the brain.

The carotid arteries are two large blood vessels, one on each side of the neck, that supply the brain with oxygen-rich blood. Over time, plaque, a combination of cholesterol, calcium, and other substances, can accumulate on the inner walls of these arteries. This narrows the passage and reduces blood flow. If a piece of plaque breaks off, it can travel to the brain and cause a stroke.

How it works:

• A catheter is inserted through the groin (femoral artery)
• It is guided to the blocked carotid artery
• A balloon expands the narrowed segment
• A stent is placed to keep the artery open
• A protection device captures debris to reduce stroke risk

Procedure duration: 1-2 hours
Anaesthesia: Local or general

When Is Carotid Artery Stenting Recommended?

Not every carotid blockage needs immediate intervention. Mild narrowing is often managed with medications and lifestyle changes.

Carotid stenting is usually recommended when:

• The carotid artery is narrowed by 50% or more, and the patient has already experienced a stroke or TIA
• The carotid artery shows 70% or greater stenosis, even without symptoms, where the risk of future stroke is significant
• The patient is not suitable for open surgery (carotid endarterectomy) due to age, heart condition, or the location of the blockage
• Previous radiation to the neck has made open surgery more complex
• The patient has had prior carotid surgery and now requires repeat treatment

Common symptoms that may indicate a carotid blockage include:

• Sudden weakness or numbness on one side of the face, arm, or leg
• Difficulty speaking or understanding speech
• Temporary loss of vision in one eye (often described as a curtain coming down)
• Dizziness or loss of balance
• Severe headache with no clear cause

These symptoms may point to a TIA, sometimes called a mini-stroke, which is a warning sign that should not be ignored. Early assessment and treatment significantly reduce the risk of a full stroke.

Carotid Stenting vs. Carotid Endarterectomy: What is the difference?

Each patient is evaluated individually to determine the most appropriate approach based on the degree of stenosis, symptoms, overall health, and imaging findings.

How Is Carotid Artery Stenting Performed in Delhi?

The procedure is performed in a specialised catheterisation lab or vascular surgery suite. Here is what the process involves:

Step 1: Pre-procedure Assessment

Before the stenting procedure, the patient undergoes a full evaluation, including Doppler ultrasound, CT angiography, or MRI of the carotid arteries. Blood tests and cardiac assessments are also done to ensure the patient is fit for the procedure. Antiplatelet medications (such as aspirin and clopidogrel) are usually started a few days beforehand to reduce the risk of clotting.

Step 2: Anaesthesia and Access

The procedure is carried out under local anesthesia with sedation in most cases, although general anesthesia may be used when appropriate. A small puncture is made in the groin (femoral artery), and a thin catheter is introduced.

Step 3: Guiding the Catheter to the Carotid Artery

Using real-time X-ray imaging (fluoroscopy) and contrast dye, the surgeon carefully guides the catheter through the blood vessels up to the narrowed carotid artery in the neck.

Step 4: Placing the Distal Protection Device

A small filter or balloon is placed beyond the blockage. This embolic protection device catches any loose plaque fragments that may break off during stenting, preventing them from reaching the brain.

Step 5: Balloon Dilation (Pre-dilation)

A small balloon catheter is advanced to the narrowed segment and briefly inflated to widen the artery.

Step 6: Stent Deployment

The carotid stent is positioned across the blockage and released. It expands to hold the artery walls open, allowing blood to flow freely. In some cases, a second balloon inflation (post-dilation) is done to ensure the stent is properly seated.

Step 7: Removing the Protection Device and Catheter

The embolic protection device is retrieved, the catheter is removed, and the puncture site in the groin is closed. The patient is then moved to recovery for monitoring.

Recovery After Carotid Artery Stenting

One of the advantages of carotid stenting over open surgery is the shorter recovery period.

• Most patients spend 1 to 2 nights in the hospital after the procedure
• There is no incision on the neck, only a small puncture in the groin
• Patients are usually advised to avoid strenuous activity for about a week
• Most people return to their normal routine within 7 to 10 days
• Antiplatelet medications are continued for at least 4 to 6 weeks post-procedure, and sometimes longer, to prevent clot formation on the stent

Post-procedure care:

• Dual antiplatelet therapy
• Regular Doppler follow-ups
• Lifestyle modifications: Stop smoking, control BP, diabetes, and cholesterol

Risks of Carotid Artery Stenting

Carotid artery stenting is generally safe, but like any interventional procedure, it carries some risks. These are discussed in detail during evaluation so that patients can make an informed decision.

During or Shortly After the Procedure

• Stroke or TIA: The most significant risk, caused by plaque debris reaching the brain. Protection devices are used to reduce this risk.
• Heart attack: Rare, but possible in patients with existing heart disease.
• Access site issues: Bruising or bleeding at the groin puncture site.
• Arterial spasm: Temporary narrowing of the artery during the procedure, usually managed immediately.
• Contrast reaction: Mild allergic reaction to imaging dye in some patients.
• Kidney impact: Temporary effect on kidney function, especially in those with prior kidney disease.

Long-Term Risks

• In-stent restenosis: Gradual re-narrowing of the artery over time.
• Stent thrombosis: Clot formation within the stent, prevented with prescribed medications.
• Hyperperfusion syndrome: Rare, may cause headache or neurological symptoms after the procedure.

Regular follow-up and medication help minimise these risks and ensure long-term outcomes.

What Is the Cost of Carotid Artery Stenting in Delhi?

The average cost of carotid artery stenting in Delhi varies from ₹1,70,000 to ₹2,64,000.

The cost depends on several factors, such as:

• The type of stent used (open-cell vs. closed-cell, with or without embolic protection)
• Hospital stay duration
• Pre-procedure investigations (CT angiography, Doppler ultrasound, cardiac evaluation)
• Anaesthesia and catheterisation lab charges
• Post-operative medications and follow-up

Many insurance plans cover carotid artery stenting when it is performed for documented clinical indications. Patients are advised to confirm coverage and get a detailed cost estimate from the hospital before the procedure.

Why Patients Trust Dr. Dinesh Kumar Mittal for Carotid Artery Stenting in Delhi?

Selecting a surgeon for a carotid procedure is not a decision to rush. The carotid arteries supply blood directly to the brain; precision, experience, and careful patient selection matter greatly. Patients across Delhi NCR rely on Dr. Dinesh Kumar Mittal for carotid artery stenting because of:

• 25+ Years of Cardiac and CTVS Surgical Experience
• Extensive expertise in managing complex carotid and vascular conditions
• Strong focus on accurate diagnosis and imaging-guided treatment planning
• Specialisation in both endovascular stenting and open carotid surgery
• Personalised treatment approach tailored to each patient’s anatomy and risk profile
• Trusted name in cardiac and vascular care at Fortis Hospital, Shalimar Bagh, Delhi
• His approach prioritises patient safety, stroke prevention, and long-term vascular health.

Book a Consultation for Carotid Artery Stenting in Delhi

Carotid artery stenosis may begin with no symptoms at all, but if left unaddressed, it can progress to a transient ischaemic attack (TIA) or a full stroke. Early consultation ensures timely intervention and significantly better outcomes.

During your consultation, Dr. Dinesh Kumar Mittal will provide:

• Detailed review of symptoms, risk factors, and medical history
• Comprehensive vascular and neurological assessment
• Evaluation of Doppler ultrasound or CT angiography reports (if available)
• Assessment of the degree of carotid narrowing and stroke risk
• Clear explanation of treatment options, stenting, surgery, or medical management
• Transparent discussion about the procedure, recovery timeline, and cost

Timely evaluation not only reduces the immediate risk of stroke but also helps prevent long-term complications such as permanent neurological damage or loss of function.

If symptoms or imaging have raised concern about your carotid arteries, getting a specialist opinion early is the most important step.