About Carotid Artery Disease / Carotid Stenosis
The carotid arteries are two blood vessels that go up either side of the neck, carrying blood to the brain. When you feel your pulse on your neck, you are feeling your carotid artery.
“Stenosis” refers to the narrowing of blood vessels, which occurs due to the thickening of the blood vessel walls and/or trapping of fatty plaques, reducing blood flow. The blood vessels, which are normally elastic, may harden and lose some of their stretchiness, worsening over time.
When this occurs in the carotid artery, it is called carotid artery disease, or carotid stenosis. The carotid artery is a common site for blockages, because the blood vessels fork, providing a perfect spot for plaques to get caught. The reduced blood flow through the carotid artery results in less blood flow to the brain, which could in turn lead to a stroke.
As the degree of narrowing progresses over time and the fatty plaque grows, it can eventually erupt, creating an injury in the wall of the artery. Blood cells and blood factors try to patch the injury, thereby creating a blood clot which can break off, travel to the brain, and block vital blood vessels.
Symptoms of Carotid Artery Disease / Carotid Stenosis
A patient with carotid artery disease will not typically exhibit any symptoms until enough of a blockage has occurred to cause a transient ischemic attack (TIA) or stroke. A TIA or stroke happens when the brain is not receiving oxygenated blood and brain function is impaired.
A TIA is sometimes referred to as a mini-stroke because the symptoms are temporary and appear to resolve on their own. However, this is a medical emergency, and help should be sought immediately, even if the patient appears to feel better.
Symptoms of TIA or stroke include:
- Sudden loss of or blurred vision in one or both eyes
- Trouble walking, talking or understanding
- Difficulty swallowing
- Weakness, tingling or numbness, typically in one side of the body
- Sudden severe headache
Sudden and/or transient loss of vision in one eye is particularly indicative of carotid disease. You may have experienced any of these symptoms in the past and been unaware that it was related to your carotid artery disease. Be sure to discuss any of the above symptoms with your physician if you have experienced them in the past, and seek immediate medical attention, if you experience them in the future.
Diagnosing Carotid Artery Disease / Carotid Stenosis
During a physical examination, your physician may have used a stethoscope to listen for abnormal sounds, called bruits, which may indicate carotid artery disease. This gives the doctor an idea whether the blood seems to be flowing normally. Your doctor may also have used diagnostic testing, including a carotid ultrasound, catheter angiography, magnetic resonance angiography or computed tomography (CT) angiography, depending on your particular situation.
Treatment Options for Carotid Artery Disease / Carotid Stenosis
The treatment of carotid artery disease varies, depending on the disease stage and medical status of an individual patient. A doctor will employ some combination of lifestyle modifications, medications and/or medical interventions.
The goal of lifestyle modification is to reduce risk factors that may contribute to carotid artery disease, such as smoking, obesity, high blood pressure, diabetes and high cholesterol. A patient may be guided through participating in a smoking cessation program, developing a heart-healthy diet, instituting an exercise plan, limiting alcohol, managing diabetes or any combination of the above.
However, lifestyle changes alone may not be enough, and a physician may recommend medication, sometimes to thin the blood and prevent blood clots, or sometimes to help with cholesterol levels. Other patients may be placed on prescriptions to help with diabetes or blood pressure, or to stop smoking.
The third form of treatment involves the use of medical procedures to help restore and maintain carotid blood flow. There are two procedures: carotid angioplasty with stenting and carotid endarterectomy.
During a carotid endarterectomy, a surgeon makes an incision into the artery and cleans it out, removing the plaque that has been causing the obstruction. By removing the plaque, blood can flow clearly through the artery, supplying the brain as it should be.
Carotid angioplasty with stenting involves widening the carotid artery to restore blood flow, then placing something in there to keep it open. First, the surgeon inserts a thin tube with a little umbrella past the site of narrowing in the carotid artery. This umbrella is opened up before the cleaning part of the procedure begins. It is supposed to catch any unwanted debris that may or may not loosen up during the procedure. Once it is assured that the umbrella is securely in place, a small balloon is inserted over a wire to the narrowing site, where the balloon is inflated, thereby making space and pushing any obstruction to the outer edge. This is called angioplasty, and is the first step to clear the path for blood to flow through without obstruction. Then the surgeon places something called a stent, a small mesh tube, into the artery to maintain the newly created space.
Because most patients with carotid artery disease do not experience any symptoms until enough damage is done to result in a transient ischemic attack or stroke, it is important to be aware of and mitigate risk factors before reaching that point. A patient can greatly reduce the risk of a life-threatening stroke by working with an experienced physician, who can develop plan that is right for them.
Why Choose Neurosurgeons of New Jersey?
Left unmanaged, carotid artery disease can have devastating, even fatal, implications. It is of vital importance to work with an experienced physician to monitor your condition and determine the best treatment options.
At Neurosurgeons of New Jersey, we have the largest network of sub-specialized neurosurgeons in the Tri-State area, including surgeons specialized in exactly how to treat carotid artery disease. The doctors of Neurosurgeons of New Jersey value patients above all else, and use their experience, expertise and cutting-edge technology to provide excellent care for every individual patient’s needs.