Comprehensive Carotid Artery Stenosis Care to Help Reduce Stroke Risk
Carotid arteries are located on each side of the neck and carry oxygenated
blood to the brain. These arteries can become obstructed by cholesterol
plaques similar to coronary arteries in coronary artery disease. Over
time plaque can build up, narrowing the artery and this can lead to a
stroke. To avoid this, patients are routinely screened with an ultrasound
or similar test to evaluate the amount of plaque within their carotid
arteries. If significant narrowing (stenosis) exists, surgery is often
recommended to remove this plaque and repair the artery to lessen your
risk of subsequent stroke. During the surgery, the surgeon will make a
small incision along the side of the neck. This allows visualization and
exposure of the artery. The artery is then opened, the plaque is removed,
and the artery is repaired often utilizing a vascular patch. This type
of surgery is called a carotid endarterectomy (CEA). Most patients may
expect to go home the day after surgery with minimal restrictions.
Pre-op routine: Before your surgery, your surgeon will see and examine you as well as
review all pertinent labs, imaging, and tests. You will have ample opportunity
to ask questions and gain a full understanding of the nature of your disease
process and the surgery to treat that disease. You will have lab tests,
lung function tests, EKG, and chest x-ray prior to surgery. Your preoperative
instructions will be provided to you in office. Follow them, and call
the office with any needs or concerns.
Frequently Asked Questions
What causes carotid artery stenosis?
Carotid artery stenosis typically develops when plaque builds up inside
the carotid arteries. This plaque can contain cholesterol, calcium, and
other substances that narrow the artery and restrict blood flow to the
brain. Risk factors may include high blood pressure, high cholesterol,
diabetes, smoking, age, and a history of vascular disease.
What are the warning signs of carotid artery disease?
Carotid artery stenosis may not cause noticeable symptoms until blood flow
to the brain is affected. Warning signs of a stroke or transient ischemic
attack (TIA) can include sudden weakness or numbness, difficulty speaking,
vision changes, dizziness, or loss of coordination. These symptoms require
immediate medical attention.
How is carotid artery stenosis diagnosed?
Carotid artery stenosis is commonly evaluated with a carotid ultrasound,
which uses sound waves to assess blood flow and identify narrowing in
the arteries. Depending on the findings, additional imaging such as a
CT angiogram or other vascular imaging may be recommended.
Can carotid artery stenosis be treated without surgery?
Some patients with carotid artery stenosis may be treated with medications
and lifestyle changes rather than surgery. Treatment can include managing
blood pressure and cholesterol, controlling diabetes, avoiding tobacco,
and taking medications prescribed by a healthcare provider. The appropriate
treatment depends on the severity of the narrowing and the patient's individual
risk factors.
When is surgery recommended for carotid artery stenosis?
Surgery may be recommended when carotid artery narrowing is significant
or when a patient has experienced symptoms related to reduced blood flow
to the brain. Your vascular specialist will consider the degree of stenosis,
symptoms, overall health, and other risk factors when determining whether
carotid artery surgery is appropriate.
What is a carotid endarterectomy?
A carotid endarterectomy (CEA) is a surgical procedure used to remove plaque
from inside a narrowed carotid artery. The surgeon makes an incision in
the neck, opens the affected artery, removes the plaque, and repairs the
artery. A vascular patch may be used during the repair.
How long does carotid endarterectomy surgery take?
The length of a carotid endarterectomy can vary based on the patient's
anatomy, medical history, and other factors. Your surgical team can provide
a more specific estimate after reviewing your imaging and determining
the appropriate approach.
What can I expect after carotid artery surgery?
Patients are monitored after surgery to ensure that blood flow to the brain
remains adequate and that there are no complications. The page notes that
most patients may expect to go home the day after surgery with minimal
restrictions. Your healthcare team will provide individualized instructions
for recovery and follow-up care.
Can carotid artery stenosis return after surgery?
Carotid endarterectomy removes existing plaque from the treated portion
of the artery, but it does not eliminate the underlying risk factors for
vascular disease. Continued medical care, healthy lifestyle habits, and
recommended follow-up appointments can help manage those risks and monitor
the treated artery.
Why is early detection of carotid artery stenosis important?
Carotid artery stenosis can progress without obvious symptoms. Identifying
significant narrowing allows healthcare providers to evaluate the patient's
stroke risk and determine whether monitoring, medical treatment, or a
procedure may be appropriate. Regular evaluation may be particularly important
for people with risk factors for vascular disease.
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