Referrals & Appointments
Stroke & Vascular Screening
Carotid artery disease is a form of disease that affects the vessels leading to the head and brain. It is the leading cause of strokes. Over 700,000 strokes occur every year in the United States, with over 160,000 of them resulting in death. Stroke is the number 3 cause of mortality in the United States, and a leading cause of disability among older Americans.
What you need to know about Carotid Artery Disease?
Blood is delivered to the brain by the 2 large carotid arteries in the front of your neck. Each carotid artery supplies oxygen to one-half of your brain. A stroke most often occurs when the carotid arteries become blocked and the brain does not get enough oxygen.
The blockage of this artery may lead to loss of movement, feeling, speech or vision. Carotid artery disease increases the risk of stroke in 3 ways:
- By fatty deposits called plaque severely narrowing the carotid arteries.
- By a blood clot becoming wedged in a carotid artery narrowed by plaque.
- By plaque breaking off from the carotid arteries and blocking a smaller artery in the brain (cerebral artery).
What are the symptoms?
Although there are no symptoms specific to carotid artery disease, the warning signs of a stroke are a good way to tell if there is a blockage in the carotid arteries. Transient Ischemic Attack (TIAs) are one of the most important warning signs that you may soon have a stroke. Sometimes called "mini-strokes," TIAs are temporary episodes of headache, dizziness, tingling, numbness, blurred vision, confusion, or paralysis that can last anywhere from a few minutes to a couple of hours. See a doctor right away if you or someone you know has the symptoms of a TIA.
Other signs or symptoms of a carotid artery blockage may be:
- Weakness or paralysis of your arm, leg, or face on one side of your body.
- Numbness or tingling of your arm, leg, or face on one side of your body.
- Trouble swallowing.
- Loss of eyesight or blurry eyesight in one eye.
- Dizziness, confusion, fainting, or coma.
- Sudden, severe headache with no known cause.
Who may be at risk?
If you have carotid artery disease, you probably also have severe coronary artery disease or have a parent who died from coronary artery disease. So, the risk factors for carotid artery disease are similar to those for coronary artery disease:
- High levels of low-density lipoprotein cholesterol (bad cholesterol) and triglycerides in the blood.
- High blood pressure
- Family history of coronary artery disease
- Lack of exercise
How Carotid Artery Disease is diagnosed?
Physical Exam: Your physician may suspect carotid artery disease based on your symptoms. He will listen to your carotid artery blood flow by placing a stethoscope on both sides of your neck. A"whooshing" sound or bruit indicates there may be a narrowing and your doctor will order further diagnostic testing.
Doppler testing: An ultrasound technician will perform this non-invasive painless test by passing a sensor over the neck area where the carotid arteries are located. The sensor generates sound waves that bounce off the arteries. The echo that bounces back is measured and changes in frequency measure the flow of blood. There will be a difference in flow in narrowed areas.
Arteriogram: A vascular interventionalist will inject dye into your arteries through a catheter placed in a small incision in your groin area. It shows a roadmap on a computer screen of the blood flow to determine a narrowing.
How is Carotid Artery Disease treated?
The treatment of carotid artery disease depends on the amount of narrowing. For blockages less than 50% medical management is the usual treatment. This includes risk factor management and possibly blood thinners. Blockages between 50-70% are treated medically unless you are exhibiting symptoms of stroke or TIA. Stenting or surgery may be recommended for blockages greater than 50% with symptoms and greater than 70% without symptoms.
Stenting: A vascular interventionalist opens the blocked carotid artery by placing an expanding balloon within the blood vessel, pushing aside the plaque and allowing a new lining to form within the stent. The procedure is performed through a cather inserted into a blood vessel at the groin site.
Surgery: Vascular surgeons perform Cartoid Endarectomy, under general anesthesia, by opening the narrowed artery in the neck. The narrowing plaque is removed and the artery is closed directly or with a patch. The procedure takes under two hours and generally patients go home the next day.
Lifestyle Modifications: You can cut your risk of carotid artery disease and stroke with the same lifestyle changes as are recommended for heart disease. If you smoke, quit. Drink no more than 2 alcoholic beverages daily. Maintain a healthy weight through proper diet and at least 30 minutes of exercise daily. Finally, "know your numbers" – keep track of your blood pressure and cholesterol by routine physician follow ups.