Carotid Artery Disease

What is carotid artery disease?

Carotid artery disease occurs when the major arteries in your neck become narrowed or blocked. These arteries, called the carotid arteries, supply your brain with blood.

As you age, a sticky substance called plaque can build up in the walls of your arteries. Eventually, when enough plaque builds up to reduce or disturb blood flow through your carotid arteries, physicians call this problem carotid artery disease.
What are the symptoms?

Carotid artery disease may not cause symptoms in its early stages. However, you may experience warning symptoms of a stroke called transient ischemic attacks, or TIAs. Symptoms of a TIA usually last for a few minutes to 1 hour and include:

 

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Feeling weakness, numbness, or a tingling sensation on one side of your body, for example, in an arm or a leg;

 

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Being unable to control the movement of an arm or a leg;

 

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Losing vision in one eye (many people describe this sensation as a window shade coming down); and

 

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Being unable to speak clearly.

Having a TIA means that you are at serious risk of a stroke in the near future. You should report TIA symptoms to your physician immediately.

What tests will I need?

If your physician suspects you have carotid artery disease, he or she will perform a carotid duplex ultrasound. In this painless test, a technician holds a small ultrasound probe to your neck.

Carotid duplex ultrasound detects most cases of carotid artery disease. However, if ultrasound does not provide enough information, your physician may order one or more of the following: CT angiography (CTA); magnetic resonance angiography (MRA); and/or angiography.

How is carotid artery disease treated?

Your treatment will depend on the severity of your condition, and whether or not you are having symptoms from the carotid artery disease, as well as your general health.  As a first step, your vascular surgeon may recommend medications and lifestyle changes.

Surgery
You may require surgery if your carotid artery disease is severe or has progressed. During surgery, your vascular surgeon removes the plaque that is blocking your carotid artery. The procedure is called carotid endarterectomy and can be performed using a local or general anesthetic, depending upon the particular situation.  The vascular surgeon makes an incision in your neck and then removes the plaque contained in the inner lining of your carotid artery. You may even be able to leave the hospital as early as the same day or the day after the procedure, depending upon how you feel. This procedure is safe and long lasting when done by a qualified vascular surgeon in the proper circumstances.

Angioplasty and stenting
A newly developed minimally invasive procedure to treat carotid artery disease is angioplasty and stenting. It is usually performed using a local anesthetic. To perform this procedure, your vascular surgeon may insert a thin tube called a catheter through a small puncture over a groin artery and guide it through your blood vessels to your carotid artery. He or she then performs an x ray picture, called an angiogram, to show the location and details of the carotid plaque. The surgeon then inserts another catheter that carries a tiny balloon that inflates and deflates, flattening the plaque against the artery walls. Next, the physician places a tiny tube called a stent in the artery to hold it open. Your hospital stay is approximately the same as with endarterectomy. Conclusive, long-term results are not yet available.  It has been approved for patients at high risk for endarterectomy, or for patients who have agreed to clinical studies.

FOR MORE INFORMATION CONTACT:

Virginia Interventional and Vascular Associates (VIVA)
1201B Sam Perry Blvd
Suite 265
Fredericksburg, Virginia 22401
(Next to Mary Washington Hospital)
Phone: (540) 654-9118
Office Hours: 8 am to 5 pm Monday - Friday
Web site: www.vivassociates.com