Strokes are caused by an interruption of blood flow to the brain and are classified by the type of blood flow interruption as listed below.
Ischemic stroke – occurs when blood vessel blockage prevents blood flow to the brain due to a plaque build-up in the carotid arteries.
Hemorrhagic stroke – occurs when the vessel ruptures inside of the brain and bleeds.
Transient Ischemic stroke or TIA – is a temporary blockage or mini-stroke which can cause permanent damage and are a sign of more severe stroke in the future.
Like Peripheral Arterial/Vascular Disease, Carotid Artery Disease is a narrowed blood flow 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 primary source of blood to your brain. Therefore, a narrowing or blockage in the carotid artery is a serious complication and requires thorough and appropriate diagnosis and treatment.
Many people with Carotid Artery Disease do not experience symptoms even with quite a bit of arterial blockage. Generally, this condition is found after the patient experiences a stroke or by a routine patient examination.
Generally, Carotid Artery Disease is 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 include:
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 of Carotid Artery Disease is generally diagnosed through 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. A Carotid Artery duplex ultrasound scan will also be performed to assess the flow of blood through the artery as well as the pressure.
The reason for the 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, losing weight, and quitting smoking are all ways that patients themselves can manage the disease and reduce the chance of blockage and stroke.
Medications may be given to lower the amount of cholesterol in the blood and lower your blood pressure. Additionally, blood thinner medications may be given to prevent blood clots.
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.
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 afterward to maintain the vessel diameter and allow the blood to flow through the artery.