What is Carotid Artery Stenting? As with blood vessels in the heart and legs, the carotid arteries are susceptible to atherosclerosis, a buildup of plaque on the inner walls of the vessel that restricts blood flow or is a source of blood clots. Factors that contribute to the disease include smoking, high blood pressure, diabetes, high cholesterol, genetics, being overweight and a family history of the disease. The carotid arteries, the two main blood vessels in the neck, can become clogged and reduce blood flow to the brain, causing 20 percent to 30 percent of all strokes. Carotid artery stenting (CAS) is a stroke prevention therapy that is an alternative to surgery. The technique involves deploying a stent, a tiny scaffold-like cylinder, in the narrowed carotid artery to prop it open. A physician performs CAS by making a tiny skin nick in the femoral artery in the groin area and advancing a small tube, or catheter, under imaging guidance, to the carotid artery. Through the catheter the doctor then inserts and deploys a stent, which acts as scaffolding in the artery to hold it open. The surgical repair of blocked carotid arteries is a safe procedure with good long term results. CAS is an important alternative treatment to surgery, particularly for patients who have had previous surgery or radiation therapy to the neck or are poor surgical candidates.