Carotid Artery Stenosis

MetroSouth Medical Center interventional cardiologists are experts in treating carotid stenosis and have been on the forefront of the developing treatments for this deadly disease. In fact, our cardiologists continue to participate in numerous clinical studies of stenting technology which provides our patients access to solutions for the prevention of stroke not available elsewhere.

When fatty deposits (plaques) clog the arteries in your neck leading to the brain, a condition called Carotid Artery Disease develops. The carotid arteries are located on each side of your neck, under your jawline, and they provide critical blood supply to your brain. Carotid Stenosis occurs when the arteries become narrowed. Appropriate treatment of carotid stenosis is critical, as it is the cause of 20-30% of all strokes.

Symptoms:
Because of slow disease development, you may have no symptoms of Carotid Artery Disease. In fact, at least 75% of all patients treated for carotid artery disease are asymptomatic. Often, the first sign of a problem may be symptoms of the brain being deprived of blood, which often presents as a stroke or transient ischemic attack (TIA), often called a ministroke. The difference between the symptoms of TIA and those of stroke is that with TIA the symptoms resolve themselves within seconds or minutes. However, recognition of those symptoms is critical as they can be the warning sign of a future stroke.

These signs and symptoms often include:

• Sudden weakness or numbness in your face, leg or arm on one side of your body
• Blurred vision or sudden blindness in one eye
• Problems with language and speech

Like other diseases of the vascular system, the consequences of carotid artery disease can be devastating. Therefore, early intervention is critical to prevent stroke. Identification of high risk patients and use of the appropriate examination and screening technologies are recommended by the cardiologist at MetroSouth Medical Center. Patients at high risk for carotid artery disease include:

• Smokers
• Diabetics
• Those with high blood pressure
• Patients with vascular disease in other parts of the body

In those patients with elevated risk, physicians should ensure they are carefully listening for a carotid bruit. The presence of carotid bruit should prompt the use of a carotid ultrasound test to further diagnose the severity of the condition. Furthermore, depending upon the risk factor make up of the patient, some physicians will consider the use of carotid ultrasound even in the absence of carotid bruit. Patients with an abnormal ultrasound should be referred to a specialist in carotid artery disease treatment.
Treatment:

• In mild to moderate cases:
  • Lifestyle modifications include quitting smoking, exercising, eating a healthy, low-sodium diet and losing weight
  • Careful monitoring with tests each year
  • Medicines including a daily aspirin or blood thinner to reduce risk of clotting, and medication to control blood pressure and/or cholesterol.
• In severe cases or for patients who have had a stroke or TIA:
  • Carotid Endarterectomy (CEA): This surgical procedure is the most common treatment and involves the surgeon opening the carotid artery at the neck and removing the plaque.
  • Carotid angioplasty and stenting: A small balloon is inserted into the carotid artery and inflated to widen it. A stent, a small mesh coil, is inserted to keep the artery from narrowing again.

MetroSouth Medical Center interventional cardiologists are available to see patients at risk for carotid artery disease and to offer second opinions on patients with a diagnosis. The MetroSouth Medical Center Physician Referral Line at 708-489-7925 can assist you in scheduling an appointment with the appropriate specialist.