Carotid Artery Disease Treatments
What is it for?
The carotid arteries are located on both sides of your neck and supply blood to your brain. Fatty deposits called plaque can build up (a condition called atherosclerosis) and block one or both of the carotid arteries. This can decrease blood flow to the brain and increase your risk of stroke. Also, a piece of the plaque may break off and travel to the brain. Patients seek treatment usually after experiencing one of the symptoms of a stroke: weakness and/or numbness in an arm or leg, sudden loss of vision in one eye or difficulty speaking. Depending on your case, treatment options a doctor may recommend include medical management, a carotid endarterectomy or a carotid stent.
How is it done?
Some patients with carotid artery disease are treated with nonsurgical methods, including optimal control of vascular risk factors such as blood pressure or cholesterol levels. Your doctor also can help you with programs to exercise more, quit smoking and improve your diet.
The surgeon makes an incision in the neck over the blockage in the carotid artery. Plaque is removed through the incision and the artery is then closed with stitches. During the procedure, a tube may be used to reroute (shunt) blood around the blockage to the brain. This procedure is performed under local or general anesthesia and your brain and heart activity will be monitored closely. Typically, the procedure requires an overnight stay in the hospital.
Carotid stenting and angioplasty
In a less invasive procedure, the carotid artery may be widened with a catheter and kept open with a stent (a small mesh tube). This procedure is typically reserved for patients who are at a high risk for surgery (this might be because a patient cannot tolerate general anesthesia or other reasons.) At the beginning of the procedure, a filter is positioned past the narrowed area of the carotid artery. A small balloon is inflated to widen the artery and a stent is placed to fully open the narrowing. As a way to prevent a stroke during the procedure, the filter will capture any particles that may have been released from placement of the stent. Carotid stenting is performed under local anesthesia. The procedure also requires a hospital admission, which is typically overnight.