The carotid arteries in the neck carry blood from the heart to the brain. Carotid artery disease results from a build-up of plaque that hardens the artery, a condition called atherosclerosis. This blockage can narrow the artery and restrict blood flow, increasing a person's risk of having a stroke. A piece of the blockage can also break off and lodge in the artery or in a smaller vessel.
Carotid artery disease does not always cause symptoms. The first alert that you have a blocked carotid artery could be a stroke. However, some people do experience warning signs. These come in the form of transient ischemic attacks, or TIAs, which may include tingling, weakness and numbness on one side of the body. A TIA is often a sign that treatment is needed for blocked arteries in order to reduce the risk of more serious complications.
Treatment for carotid artery disease may take several different forms, depending on each patient's condition, overall health, age and lifestyle. The goal of all treatments is to clear a blockage within the carotid artery and restore blood flow to the brain, which can be done through a surgical endarterectomy or angioplasty with stent placement.
Carotid endarterectomy is a surgical procedure performed to remove plaque buildup from the carotid arteries. This procedure is usually recommended for patients that have suffered from a transient ischemic attack (TIA) or a stroke, and whose carotid arteries are at least 70 percent clogged.
The procedure begins with an incision in the neck, exposing the narrowed carotid artery. At this point, a shunt may be used to direct blood flow away from the area being operated on. Then, the surgeon opens the artery and removes the plaque, usually in one piece. In some cases, a vein from the leg is grafted onto the carotid artery to widen it. The shunt is then removed and all incisions are closed. Patients will need to stay in the hospital for one to three days after a carotid endarterectomy.
Carotid stenting involves the implantation of a metal mesh tube (a "stent") to hold a clogged artery open so blood can flow through it unobstructed. The stent is put in place using a technique called balloon angioplasty. A small tube known as a catheter with a tiny balloon on the end is inserted into an artery in the groin, snaked up to the carotid artery, and gently expanded, pushing open the blockage and restoring blood flow. The stent is then put in place to ensure that the artery stays open.
After the procedure, patients will usually need to stay in the hospital overnight and may experience bruising, swelling, or tenderness. Stenting is a relatively new procedure for carotid disease and is usually only recommended for patients with severe stenosis (blockage) who experience symptoms from the restricted blood flow.
Testing for Carotid Artery Disease exam can be done in our Vascular Lab Appointment Request