Carotid Stents: A Patient's Perspective

Our feature story in this issue of Keeping in Circulation describes a new treatment for treating carotid artery disease with carotid stents. What does this treatment entail from the patient's perspective? We interviewed three patients who were involved in early studies of carotid stents. You'll read, in their own words, about the symptoms that led to the surgery, what they know about the surgery, whether recovery was easy or difficult, and how they feel after the successful completion of the procedure. We thank these patients for their time and willingness to share information.

The patients:
Mary Appling is in her 80s and had her carotid stent implanted in 2002.
Carol Cisky is 68 years old and received her stent in 2002.
Charles Phinicie is 86 years old and received his stent in 2003.

What symptoms did you have that prompted the procedure?
Mary: I had no symptoms. My doctor is very thorough and since he knew I had high blood pressure, he ordered regular ultrasounds of the carotids. The first time I had narrowing, my surgeon recommended an endarterectomy—a cleaning out of the arteries. That was early in 2002. At six months the ultrasound showed the narrowing was back. It was 90 percent narrow by then. He then recommended the stent as the thing to do.
Carol: I had an endarterectomy on my carotid five years before the stent. It was done because of narrowing in the carotid and headaches with my high blood pressure. I was checked every year with an ultrasound and they found more narrowing. There were no other symptoms.
Charles: I had none. The ultrasound showed severe narrowing in the carotid. I have a heavy family history of strokes—there are lots in the family.

What were your biggest concerns?
Mary: I was really not concerned, but he did warn me there was some risk of stroke.
Carol: I was very nervous about the thought of redoing the surgery and they assured me this procedure was very simple. I was also nervous about the possibility of blood clots and stroke.
Charles: I had none.

What do you understand about what they did?
Mary: They put the stent in the narrow part of the artery. Back then they had no stents with medicine in them, so mine had no medicine in it. If I have to have another, I hope they will use one with medicine.
Carol: They put the stent in the narrow part of the artery.
Charles: Nothing—I was asleep.

What was your recovery like?
Mary: I spent the night and went home the next morning. I felt fine. I was able to go back to my normal activities immediately. I could do whatever I wanted.
Carol: I stayed overnight and missed only one day of work. I could do anything I wanted.
Charles: I came home the same day and just lay around most of the day. There were no restrictions and I went back to normal activities the next day.

What is your follow up schedule for the stent?
Mary: I get ultrasounds every six months.Carol: I get a yearly ultrasound and keep my blood pressure under control.
Charles: I get a check up and an ultrasound every year. I do not have high blood pressure, so I don't have to worry about that.

Have you had any problems since the stent?
Mary: The ultrasounds have shown the stent is all right. I have had no problems since then. My other side is 50-60 percent narrowed, but that is not enough to need anything done.
Carol: No.
Charles: No.

Has the stent changed your life in any way?
Mary: No.
Carol: No.
Charles: No.

What other comments or advice would you give anyone who is thinking about this procedure?
Mary: It doesn't pay to have doubts. If you are nervous, ask for medications. You should know everything—check the Internet and other sources. Just go ahead and do it if it is necessary.
Carol: It is the way to go. Use the Internet to read up on it. It is the least invasive. You are not restricted in any way. There is a quick recovery.
Charles: Go ahead and have it done. I also have a son who has had it done and we are both fine.