Carotid Artery Disease
Carotid artery disease is a disease in which a waxy substance called plaque builds up inside the carotid arteries. You have two common carotid arteries, one on each side of your neck. They each divide into internal and external carotid arteries.
The internal carotid arteries supply oxygen-rich blood to your brain. The external carotid arteries supply oxygen-rich blood to your face, scalp, and neck.
Causes of Carotid Artery Disease
Carotid artery disease seems to start when damage occurs to the inner layers of the carotid arteries. Major factors that contribute to damage include:
*Having any of these factors doesn't guarantee that you'll develop carotid artery disease. However, if you know that you have one or more risk factors, you can take steps to help prevent
or delay the disease.
- High levels of certain fats and cholesterol in the blood
- High blood pressure
- High levels of sugar in the blood due to insulin resistance or diabetes
When damage occurs, your body starts a healing process. The healing may cause plaque to build up where the arteries are damaged.
The plaque in an artery can crack or rupture. If this happens, blood cell fragments called platelets will stick to the site of the injury and may clump together to form blood clots.
The buildup of plaque or blood clots can severely narrow or block the carotid arteries. This limits the flow of oxygen-rich blood to your brain, which can cause a stroke.
Treatment for Carotid Stenosis
- What is Carotid Endarterectomy?
- Who Needs One?
- What is Angioplasty and Stenting?
What Is Carotid Endarterectomy?
- The procedure removes the plaque from inside the artery wall restoring blood flow to normal.
- A small incision in the neck is required and in many cases, local anesthesia can be used.
- Most patients go home the morning after surgery and quickly resume normal activities without restrictions.
- There is some risk of having a stroke during the procedure. However, this risk is far outweighed by the risk of stroke if nothing is done. Nearly 500 carotid endarterectomies found a stroke rate of 0.2%, which is among the best results reported anywhere in the world.
Who Needs Carotid Endarterectomy?
Your doctor may recommend carotid endarterectomy if you have carotid artery disease. CEA can help prevent strokes in people who have this disease. CEA is most helpful for people who have carotid artery disease and one or more of the following:
- A prior stroke.
- A prior transient ischemic attack (TIA), also called a "mini-stroke." During a TIA, you may have some or all of the symptoms of a stroke. However, the symptoms usually last less than 1–2 hours (although they may last up to 24 hours).
- Severely blocked carotid arteries (even if you don't have stroke symptoms).
What Is Carotid Angioplasty And Stenting?
Carotid angioplasty is a non-invasive procedure performed after the diagnostic angiogram. The carotid angioplasty procedure can be performed the same day as the diagnostic angiogram or days or weeks after the angiogram. During angioplasty, a balloon catheter is guided to the area of the blockage or narrowing. When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls to improve blood flow.
During the angioplasty procedure, a carotid stent (a small, metal mesh tube) is placed inside the carotid artery at the site of the blockage and provides support to keep the artery open.
For patients who meet certain eligibility criteria, carotid stenting offers a less invasive approach than carotid endarterectomy, the traditional surgical treatment for carotid artery blockages.
Recently reviewed series of our nearly 500 carotid endarterectomies and found a stroke rate of 0.2%, which is among the best results reported anywhere in the world.
Please call with any questions:
Daniel J. McGraw, MD
705 Garfield Avenue, Suite 460
Parkersburg, WV 26101