Stopping Carotid Artery Stenosis in its Tracks
Carotid artery disease (or stenosis) causes up to one-third of strokes in the United States. When plaque builds up in your carotid arteries, it blocks the normal flow of blood through your body and to your brain, which can lead to both minor and major strokes. At Rochester Regional Health, our expert surgeons have trained extensively in treating carotid artery disease and offer the latest in minimally invasive and open surgery techniques to clear your arteries.
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What is Carotid Artery Disease?
Carotid artery disease (also called carotid artery stenosis) occurs when your carotid artery becomes blocked. You have two carotid arteries?on either side of your neck?and these large arteries bring blood to your brain, face, and head. When they?re unblocked, the arteries are smooth and open, allowing blood to flow smoothly.
When plaque builds up in your arteries, it blocks the normal flow of blood through your carotid artery, putting you at a higher risk for stroke. You can develop carotid artery disease in one or both of your carotid arteries, and the condition will worsen over time without medical care, which can lead to stroke with severe complications.
Symptoms
Oftentimes, symptoms of carotid artery disease are not evident, especially in the early stages. One of the reasons why yearly check-ups?especially as we age?are important is because your doctor may notice an atypical sound (called a bruit) when listening to your pulse. A bruit makes a very distinctive, faint whistling sound that is a sign of a carotid artery blockage.
As carotid artery blockages advance, the first sign may be a mini-stroke. These mini-strokes are also called transient ischemic attacks (TIAs) and need immediate medical care. Quick medical intervention dramatically reduces the chance of long-term damage.
Stroke and TIA symptoms include:
- Blurred vision and/or vision loss
- Confusion
- Memory loss
- Numbness or weakness in your body or one side of your body
- Thinking, reasoning, memory, or speech problems
Risk Factors for Carotid Artery Disease
A family history of stroke can put you at risk for carotid artery disease. Other risk factors include:
- Being 65+, especially if you?re male
- Diabetes mellitus
- Family history of stroke
- High blood pressure
- High cholesterol
- High triglycerides
- Neck trauma
- Smoking, alcohol use, or recreational drugs
Causes of Carotid Artery Disease
Like many other arterial diseases, carotid artery disease can develop if you have hardened arteries (atherosclerosis). This buildup of plaque in your arteries can affect blood flow to the brain, resulting in a stroke or a TIA (Transient Ischemic Attack, or mini-stroke).
Diagnosis
Diagnosing carotid artery disease starts in a familiar place?with a physical exam. Your vascular surgeon will listen to the blood flow in your neck, focused primarily on listening for a bruit. Blood tests may be ordered to check your cholesterol, blood sugar, and triglycerides, allowing us to accurately assess your overall health and likelihood of carotid artery disease.
If necessary, your provider may also order imaging tests for a closer look at blood vessels in your neck and brain. The lab tests they order may include:
- Cerebral angiography - an imaging test that maps the blood vessels in your brain
- CT angiography (CTA) - a test that uses contrast dye (material) and a series of X-rays to show detailed images of your blood vessels
- MR angiography (MRA) - a test that utilizes a strong magnetic field to show clear images of a carotid artery blockage
- Carotid duplex ultrasound - this non-invasive ultrasound of your carotid arteries checks how your blood is flowing through the artery
Your vascular surgeon will use these tests, your overall health, and your age to determine the best course of treatment for your individual needs.
Treatment
Your team at Rochester Regional Health is filled with expert providers trained extensively in treating arterial conditions. Treatment for carotid artery disease is focused on clearing out blockages to reduce the likelihood of stroke. Your treatment may utilize one or more than one of the treatments below to best address your blockage.
Medications
For some, blood-thinning medications like aspirin, clopidogrel, warfarin, and others can reduce the risk of stroke. Your provider will assess your age and overall health to determine what medication best fits your needs, as well as blood pressure and cholesterol medication.
Surgery
From minimally-invasive surgical options to the more traditional treatment for carotid artery disease, the vascular surgeons at Rochester Regional Health have surgical options to meet every need.
Carotid Angioplasty and Stenting
During a carotid angioplasty and stenting, your vascular surgeon will place a stent (a small mesh tube) in your artery, which holds the artery open and permits healthy blood flow. This works to reduce the likelihood of worsening blockages and stroke.
Carotid Endarterectomy
Carotid endarterectomy is the gold standard treatment for carotid artery disease. It involves an incision in the neck where your vascular surgeon will open up your carotid artery and manually remove the plaque causing the narrowing.
Transcarotid Artery Revascularization (TCAR)
This minimally-invasive procedure restores blood flow through your carotid artery. During the procedure, your surgeon will reverse the blood flow in your carotid artery, theoretically reducing the risk of intraoperative stroke, and will fix the blockage using a stent.