Carotid Artery Disease

Carotid Artery Disease2018-09-18T21:59:50+00:00

Carotid Artery Disease

Like Peripheral arterial/vascular disease Carotid Artery Disease is a narrowed flow of blood through the vessel. This narrowing or blocked vessel becomes occluded by fatty deposits of plaque built up along the vessel wall leading to atherosclerotic disease. The Carotid artery is the main source of blood to your brain and therefore a narrowing or blockage in the carotid artery is a very serious complication and requires thorough and appropriate diagnosis and treatment.

Symptoms

Many people with Carotid Artery Disease experience no symptoms even with severe blockage. Generally, this condition is found after the patient experiences a stroke or through other a routine patient examination. In rare occasions Carotid Artery Disease may cause ringing in the ears or fainting because of the lack of blood flow to the brain. Other symptoms may include weakness, numbness, slurred speech or facial drooping.

Causes

Generally caused by atherosclerosis, where a build up of plaque in the arteries reduces the flow of blood or blocks the flow entirely. This lack of blood flow and reduced oxygen supply to the brain can lead to stroke.

Risk Factors

Sedentary lifestyle, Overweight obesity, Diabetes, smoking, high cholesterol levels, high blood pressure, Family history, high fat diet, and age above 75 are all factors

Diagnosis

Thorough physical examination and medical history. Your physician will also most likely be looking for a (bruit) swooshing sound in the carotid artery that is indicative of a narrowed artery. An Carotid Artery duplex ultrasound scan will also be performed to assess the flow of blood through the artery as well as the pressure. A CT or MRI may be done also to assess for stroke.

Treatments

Thereason for treatment of carotid artery disease is to reduce or mitigate the possibility of stroke.

For mild blockage:

lifestyle changes such as eating a healthier diet, reducing salt intake, exercising regularly, loosing weight, and quitting smoking.

Medication management:

to lower the amount of cholesterol in the blood and your blood pressure. Additional blood thinner medications may be given to prevent blood clots.

Surgical intervention:

Carotid endarterectomy – generally performed when there is a blockage of 50% or above accompanied with symptoms such as a stroke.

TCAR –Western Vascular Institute is pioneering the use of a breakthrough technology called TransCarotid Artery Revascularization (TCAR) to treat patients with carotid artery disease who are at risk for open surgery. While any repair of the carotid artery carries some risk of causing a stroke because of the repair itself, TCAR was designed to help minimize that risk by keeping potential stroke causing fragments away from the brain.  Like the open surgery, carotid endarterectomy (CEA), this new procedure involves direct access to the carotid artery, but through a much smaller incision at the neckline just above the clavicle instead of a longer incision on the neck. During the TCAR procedure, a tube inserted into the carotid artery is connected to a system that temporarily directs blood flow away from the brain to protect against dangerous debris from reaching the brain during the procedure. Surgeons then filter the blood before returning it to a vein in the groin, and a stent is implanted directly into the carotid artery to stabilize the plaque and prevent future strokes. The entire procedure is performed in less than half the time of CEA limiting the stress on the heart and significantly cutting the risk of the patient having a stroke or heart attack during the procedure.

Patients who undergo the TCAR procedure recover quickly (typically spending just one night in the hospital) and almost always go home the next day to return to full and productive lives with less pain, smaller scars and a reduced risk of future strokes.  Your physician may recommend the TCAR procedure if you’ve been diagnosed with carotid artery disease and are not a suitable candidate for CEA. This may depend on your age or other existing medical conditions. For more information about TCAR, call us to schedule a consultation with one of our vascular surgeons.

Carotid angioplasty / stenting –This procedure is performed to treat narrowed or occluded carotid arteries. In this procedure the Vascular Surgeon inserts a wire through the groin and guided via x-ray imaging to the carotid artery. Once there the balloon is placed to expand the narrowed section and a stent is left in place afterwards to maintain the

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