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Carotid Artery Disease

Cause and What to Watch For

Carotid artery disease is caused by a narrowing of the blood vessels that supply the brain. This narrowing is due to a blockage in the artery primarily composed of cholesterol and inflammatory cells. If the blockage progresses pieces of the blockage can break off and go to the brain, causing a stroke.

Symptoms that you may experience:

  • Visual loss in one eye: Usually like a shade being pulled down
  • Speech difficulty: Hard to understand or form words
  • Facial changes: One side of the face may droop
  • Weakness: On one side of the body of an arm or leg or both
  • Balance: Sudden loss of balance with profound dizziness

How to Diagnose Carotid Artery Disease

Your doctor will perform a physical exam and listen to your neck arteries. Several imaging tests diagnose possible carotid artery disease, including carotid ultrasound, CT scan of neck arteries and MRI scan of neck arteries.

How to Treat Carotid Artery Disease

Your doctor may prescribe medications to help manage the disease and prevent buildup of additional cholesterol in the carotid artery. Controlling blood pressure and making healthy lifestyle changes are important. A procedure to open blocked arteries may be necessary.

  • Medications
    • Blood thinners: Aspirin, Plavix, Aggrenox
    • Cholesterol therapy: Statins, PCSK9 inhibitors, Zetia, Vascepa
  • Blood pressure control
  • Diet
  • Exercise
  • Smoking Cessation
  • Procedures to Fix Blocked Arteries
    • Angioplasty and Stent
      • Small tube placed in the leg or wrist artery and taken up to the neck arteries. Pictures taken of the neck arteries. Blockages moved out of the way with a small balloon and then a stent is used to keep the artery open and trap the blockage. Procedure done with mild sedation. Usually stay in hospital overnight.
    • Carotid Surgery (Endarterectomy)
      • Surgeon opens the artery and removes the blockage, then covers the area with a patch. Done with full anesthesia. Usually stay in hospital overnight.
    • TCAR (Transcarotid Artery Revascularization)
      • Newer procedure in which a small surgery is done in the neck to gain access to the artery and then a stent is placed.