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Carotid Artery Disease

What is Carotid Artery Disease?

Your carotid arteries are the two main arteries that carry blood from your heart, up through your neck, to your brain. Healthy carotid arteries are smooth and unobstructed, allowing blood to flow freely to the brain and providing oxygen, glucose, and other nutrients that your brain cells need.

Typically, with age, the carotid arteries build up plaque, made up mostly of fat and cholesterol. Plaque narrows the inside of the arteries and makes them stiff. This process is commonly referred to as “hardening of the arteries,” or atherosclerosis.

Carotid artery disease results when the carotid arteries become narrow or obstructed and create a risk of the plaque traveling to the brain and causing a stroke.

Stroke is the third leading cause of death in the United States and the leading cause of permanent disability in older adults. Approximately 25% of strokes occur when bits of carotid plaque or clot break off and flow to the brain.

If left untreated, carotid artery disease may lead to stroke, where the lack of oxygen and other essential nutrients cause damage to the brain. Depending on its severity, a stroke can be fatal.

Risk Factors

Know your risk for Carotid Artery Disease

Anyone can develop carotid artery disease, but there are certain risk factors that can increase the likelihood of developing this serious condition.

These conditions include:

  • Age
  • High blood pressure
  • Diabetes
  • Smoking
  • High cholesterol
  • Obesity
  • Lack of exercise
  • Family history of atherosclerosis and/or stroke

Symptoms of Carotid Artery Disease

There may be no symptoms in the early stages, and stroke could be the first sign of the condition.

Stroke, however, typically has warning signs, referred to as mini-strokes or transient ischemic attacks (TIA’s).

Mini-stroke symptoms are usually temporary, lasting a few minutes to a few hours, and should be treated as serious medical emergencies requiring immediate treatment, as they are strong predictors of future stroke.

Some symptoms of stroke or TIA may include:

  • Weakness, numbness, or tingling on one side of the body.
  • Inability to control movement of a body part.
  • Loss or blurred vision in one or both eyes.
  • Inability to speak clearly.
  • Difficulty talking or comprehending what others are saying.
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Diagnosing Carotid Disease

Your physician will evaluate your medical and family history, take blood tests, and conduct a physical examination. If your physician suspects carotid artery disease, it can be confirmed by undergoing non-invasive duplex ultrasound examination. The ultrasound can also determine the severity of the disease. If you experience symptoms of a mini stroke, seek medical attention immediately. Your physician may then ask you to see a vascular surgeon, as they are highly trained in every type of vascular procedure.

What are the treatment options?

Depending on the severity of your condition, treatment options may include lifestyle changes, medications, or procedures such as carotid endarterectomy or carotid artery stenting. Vascular surgeons use two approaches to carotid artery surgery. The procedures are similar, but having both options enables your surgeon to choose the one that meets your particular needs.

Traditional carotid endarterectomy

Traditional carotid endarterectomy involves an incision along your carotid artery. It enables your surgeon to more easily use a shunt, a tube to keep blood flowing to your brain during surgery. The surgeon closes the artery with a patch from another blood vessel in your body or a synthetic or biologic material.

Eversion endarterectomy

Eversion endarterectomy uses an incision that crosses the carotid artery. Your surgeon can close the incision without a patch, which reduces the chance of carotid artery disease reoccurring in the future.

Transcarotid Arterial Revascularization

Some patients also benefit from a newer, minimally invasive procedure producing excellent results and outcomes called TCAR. Recovery is faster than traditional surgery, with minimal pain and less scarring.