Diagnosing and Treating Carotid
Carotid artery disease involves blockages in the two branched arteries leading from the neck to the brain. Those who smoke or have smoked in the past, have high blood pressure or cholesterol, and those with diabetes are at higher risk of accumulating fatty deposits that harden these vital arteries. When blood flow through these arteries is restricted, a “transient ischemic attack” (TIA) or mini-stroke can occur. A temporary feeling of paralysis, weakness or tingling in an extremity, or loss of vision in one eye can all be signs of a mini-stroke, which often can precedes a major stroke.
Blank Center specialists often listen for “bruits”—a rumbling sound made when blood passes through a restricted vessel. To confirm narrowing of the artery, a carotid ultrasound or CT angiogram may be performed. Other diagnostic tests include MRIs or cerebral angiograms. Cerebral angiograms involve inserting a catheter into an artery, then injecting contrast fluid to highlight the carotid artery under x-rays.
Depending on the seriousness of the blockage, the carotid arteries may be treated with lifestyle modification, medication, or surgery.
Carotid Artery Stenting
In some cases, surgeons can relieve blockages in the carotid arteries through carotid artery stenting. Stents are small mesh tubes, or metal “cages” that are inserted and expanded to ensure blocked arteries remain open after angioplasty. The procedure is performed with a neuroprotection device to prevent any loose plaque particles from flowing to the brain and causing a stroke.
A one-night hospital stay is usually required after stent placement.
Carotid Endarterectomy Procedure
Before and After
A common procedure for treatment of blocked carotid arteries is called carotid endarterectomy. Our surgeons make an incision in the skin over the artery, then open the artery itself. Blood flow is temporarily stopped by clamping the artery above and below the blockage. If other arteries are not delivering enough blood to the brain, a shunt is used to maintain blood flow during the procedure. The surgeon then removes the obstructing plaque and closes the artery incision with a patch or stitches. Before the neck incision is closed, the surgeon may place a drain tube to keep fluids from building up during surgery.
Patients undergoing carotid endarterectomy will likely spend one or two nights in the hospital, followed by a week of recovery at home.
To refer a patient to The Blank Vascular Center, please call 215-887-5934.