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stable result and antiplatelet plan confirmed at about 1-month review, with ultrasound surveillance later."},"fly_home_after_days":{"min":3,"max":7,"unit":"days","qualifier":"Uncomplicated case counted from stenting, with stable neurological status, healed access site and physician clearance."},"follow_up_visits":[{"purpose":"assessment","requirement":"routine","after":{"min":25,"max":35,"unit":"days","qualifier":"Clinical review, medication check and often duplex ultrasound."}},{"purpose":"result_review","requirement":"routine","after":{"min":150,"max":210,"unit":"days","qualifier":"Surveillance duplex ultrasound for in-stent restenosis; later surveillance varies."}}],"indications":["Symptomatic high-grade stenosis, high risk for open surgery","Selected asymptomatic stenosis of 70% or more in high-risk patients","Restenosis after carotid endarterectomy","Prior neck radiation or hostile neck anatomy","Contralateral vocal cord palsy, tracheostomy or contralateral carotid occlusion","High bifurcation or other lesions hard to reach surgically"],"main_risks":["Periprocedural stroke or TIA, mostly minor; higher over age 70","Myocardial infarction","Death","Bradycardia and hypotension from baroreceptor stimulation","Access site hematoma, bleeding or pseudoaneurysm","Retroperitoneal hemorrhage","Carotid dissection or incomplete stent deployment","Contrast-related kidney injury or allergic reaction","Cerebral hyperperfusion syndrome or intracranial hemorrhage","In-stent restenosis or stent thrombosis","Bleeding from antiplatelet therapy"],"pain":"Minimal; mild groin or neck discomfort controlled with simple analgesia.","preparation":["Neurological assessment and comorbidity review","Carotid imaging (duplex, CT or MR angiography) including arch anatomy","Dual antiplatelet therapy arranged by treating team beforehand","Kidney function and contrast allergy review, with premedication if needed","Fasting as instructed","Medication review with the physician"],"recovery_timeline":[{"phase":"First 24 hours","description":"Monitoring of access site, blood pressure and neurological status; strict blood pressure control reduces hyperperfusion risk.","restrictions":["Keep the access leg straight as instructed","No driving"]},{"phase":"First week","description":"Walking and light daily activity; return to desk work if well.","restrictions":["Avoid heavy lifting and strenuous activity"]},{"phase":"Following weeks","description":"Continue dual antiplatelet therapy and vascular risk-factor control, with scheduled follow-up.","restrictions":["Avoid strenuous exercise until cleared"]},{"phase":"At any time","description":"Seek urgent assessment for new weakness, speech or vision changes, severe headache, or groin or neck swelling or bleeding.","restrictions":[]}],"rehabilitation_days":{"min":3,"max":7,"unit":"days","qualifier":"Ordinary functional recovery after uncomplicated stenting without deficit; no formal program usually needed."},"result_longevity":"Stent usually remains in place long term; stroke protection depends on restenosis surveillance, antiplatelet adherence and vascular risk-factor control.","revision_rate_pct":{"min":2,"max":6,"unit":"percent","qualifier":"Repeat revascularization for in-stent restenosis over about 5 years."},"scars":"Transfemoral route leaves only a groin puncture site; transcarotid route leaves a small neck incision.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One procedure per treated carotid artery."},"stages":[{"code":"stenting","label":"Angioplasty and stent placement with embolic protection","after":{"min":0,"max":0,"unit":"days","qualifier":"Single procedure."}}],"qualifier":"Single endovascular procedure per treated artery."},"success":{"metric":"Freedom from periprocedural stroke or death","value":95,"unit":"percent","horizon":"30 days","population":"Mixed symptomatic and asymptomatic adults; lower in symptomatic and older patients.","evidence_status":"limited"},"techniques":[{"name":"Transfemoral carotid stenting with embolic protection","suits_whom":"Suitable aortic arch anatomy; most common route.","recovery":"Femoral access closed with a closure device; groin monitoring."},{"name":"Transcarotid artery revascularization (TCAR) with flow reversal","suits_whom":"Hostile aortic arch or high embolic risk with adequate common carotid length; needs a small neck incision.","recovery":"Neck incision closed; femoral venous sheath site compressed."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":1,"max":2,"unit":"hours","qualifier":"One carotid artery, uncomplicated case, excluding preparation and observation."},"initial_assessment_documents":["Carotid duplex ultrasound report","CT or MR angiography of neck and head","Aortic arch imaging","Recent neurological or stroke event reports","Cardiology report with ECG","List of antiplatelets and anticoagulants"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single procedure; 3-7 day stay with overnight monitoring until cleared to fly. Follow-up ultrasound possible at home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the qualifications of the medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check that you can ask the treating team questions about your treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Check that you are satisfied with the facilities and standards of the clinic or hospital","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Check how your aftercare will be coordinated before you travel","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Check that you understand the possible complications and side effects of the treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Make sure you understand the possible complications and side effects that could arise from your treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"A hard sell when offered treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare Get a second opinion","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"A lack of information about the treatment offered","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare Get a second opinion","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"Pressure to make a quick decision about treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare Get a second opinion","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F4","text":"No discussion of possible complications before booking treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare Get a second opinion","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Facial asymmetry or speech issues","urgency":"emergency","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/16850-carotid-artery-disease-carotid-stenting","host":"my.clevelandclinic.org","quote":"This includes facial asymmetry, any speech issues (like an inability to talk), or an inability to move or feel parts of your body.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Bleeding or 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