Guidance
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Carotid artery stent placement for asymptomatic extracranial carotid stenosis.
NICE has also produced guidance on carotid artery stent placement for symptomatic extracranial carotid stenosis (NICE interventional procedure guidance 389, April 2011).
Description
The main arteries in the neck (the carotid arteries) can become narrowed by fatty deposits. Blood clots can form on these fatty deposits and fragments can detach and lodge in thinner arteries that supply blood to parts of the brain, causing a transient ischaemic attack (TIA, sometimes called a ‘mini stroke’) or a stroke. Patients who are asymptomatic have this narrowing but without any previous health problems resulting from it.
In this procedure a metal mesh called a stent is used to widen the narrowed carotid artery. This procedure does not involve making a cut in the neck. Instead a fine wire is inserted into an artery in the leg and passed up into the carotid artery, and the stent is then moved into place along the wire. Some stenting also includes protective devices, to help to prevent any fragments loosened by the stent insertion from reaching smaller arteries and causing a stroke.
Coding and clinical classification codes for this guidance