Carotid Artery Disease

The major arteries in your neck are known as the carotid arteries and supply blood to your brain.  These arteries run from the aorta in your chest to the base of your brain.  When these arteries become blocked with plaque (a combination of cholesterol, calcium and fibrous tissue) to the point where blood cannot flow efficiently, it is known as carotid artery disease.  This is a serious health issue and it can lead to stroke if untreated. The plaque in the arterial wall can lead to a stroke when it causes a clot to form in the arterial wall or on its inner surface.  The clot may completely block the carotid artery restricting blood flow to the brain causing a stroke.  Sometimes portions of the clot or fragments of the plaque break loose and block the smaller arteries in the brain also resulting in a stroke.

The symptoms of stroke can include a feeling of weakness and/or a numbness or tingling sensation on one side of your body or in an arm or leg.  There is usually no pain.  Other symptoms include a loss of vision in one eye and/or an inability to speak clearly.   

Stroke is a serious health issue being a major cause of disability and the third most common cause of death in adults.

Stenting

Carotid angioplasty and stenting is a relatively new procedure for patients who are not in good enough health to undergo surgery – this includes people with severe heart or lung disease and those who have undergone neck operations or radiation for neck tumors.

In carotid angioplasty, the surgeon inserts a catheter into the groin artery. It is then threaded through the network of arteries that lead to the area that has narrowed. Once at the location of the narrowed passage, a small balloon is inflated to widen the artery. Finally, a metal stent (an expandable tube of metal mesh) is left in the area that had narrowed, restoring blood flow.

Surgery

For most people with carotid artery disease the treatment is a surgical procedure where the obstructing plaque is carefully removed from the inside of the artery.  This operation is called carotid endarterectomy.  A small incision over the affected artery on the side of the neck is required.  There is surprisingly little discomfort and most people may be discharged home in 24 to 48 hours.

Medical Management

In some cases your doctor may opt to treat your carotid artery disease with medical or non-surgical therapy.  The carotid artery plaque can often be stabilized with good control of diabetes, blood pressure and lipids.  Anti-platelet therapy also decreases the risk of stroke.