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Carotid Artery Disease McAllen Heart Surgeons performs carotid endarterectomy via minimally invasive (~3cm) neck incisions, with a perioperative stroke rate of <0.1%. Patients are treated for isolated carotid artery disease, and patients are also screened for carotid artery stenosis using dupplex ultrasound before all heart operations. What are the carotid arteries? 
Your arteries carry oxygen-rich blood away from the heart to the head and body. There are two carotid arteries (one on each side of the neck) that supply blood to the brain. You can feel your carotid arteries by feeling the pulse on your lower neck, on either side of your windpipe. The carotid arteries supply the large, front part of the brain, where thinking, speech, personality and sensory and motor functions reside. There are two smaller arteries, the vertebral arteries, which run through the spine and supply the back part of the brain (the brainstem and cerebellum). |
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Like the blood vessels of the heart (coronary arteries), the carotid arteries also develop atherosclerosis, the build-up of fat and cholesterol deposits, called plaque, on the inside of the arteries. Over time, the build-up narrows the artery, decreases blood flow to the brain and can lead to a stroke. A stroke can occur if
A stroke is similar to a heart attack. A stroke occurs when brain cells (neurons) are deprived of the oxygen and glucose carried to them by blood. Oxygen and glucose are essential for neurons to function and survive. If the lack of blood flow lasts for more than 3 to 6 hours, the damage is usually permanent. What are the risk factors for carotid artery disease? The risk factors for carotid artery disease is similar to those for coronary artery disease:
If you have coronary artery disease, you are more likely to get carotid artery disease. What are the symptoms of carotid artery disease? There may not be any symptoms of carotid artery disease. However, there are warning signs of a stroke. A transient ischemic attack (also called TIA or "mini-stroke") is one of the most important warning signs of a stroke, and is a strong indicator of carotid artery disease. A TIA is a temporary episode of:
A TIA may last a few minutes or a few hours. A TIA is a medical emergency since it is impossible to predict if it will progress into a major stroke. If you or someone you knows experiences these symptoms, get emergency help (Call 9-1-1 in most areas). Immediate treatment can save your life or increase your chance of full recovery. How is carotid artery disease diagnosed? Carotid artery disease may not have symptoms. It is important for those at risk for carotid artery disease to have regular physical exams by their doctor. A doctor will listen to the arteries in your neck with a stethoscope. An abnormal rushing sound, called a bruit (BROO-ee) may indicate you have carotid artery disease. Bruits are not always present when blockages are present and may be heard at times even with minor blockages. It is important to let your doctor know if you have had any symptoms of carotid artery disease, such as those listed above. Diagnostic tests for carotid artery disease include: Carotid Duplex Ultrasound - An imaging procedure that uses high-frequency sound waves to view the blood vessels in the neck and to determine the presence of narrowing in the carotid arteries. This study is recommended in anyone with heart disease and anyone over the age of 60. Carotid Angiography (carotid angiogram, carotid arteriogram, carotid angio) - If carotid artery disease is suspected, prior to treatment, your doctor may schedule an arteriogram. This is an invasive imaging procedure that involves inserting a catheter into a blood vessel in the arm or leg, and guiding it to the carotid arteries with the aid of a special x-ray machine. Contrast dye is injected through the catheter so that x-ray movies of your carotid arteries are taken. Computerized Tomography (CT Scan) - a CT of the brain may be performed if there is a possibility a stroke has already occurred. This test will reveal areas of damage on the brain. How is carotid artery disease treated? Carotid artery disease is treated by:
Lifestyle modification To prevent further progression of disease, lifestyle modification is recommended to limit all risk factors for coronary and carotid artery disease. These include:
Medications Blood-thinner (anticoagulant) medications - all patients with carotid disease should be on aspirin to decrease the risk of stroke due to blood clots. In some cases, Coumadin (warfarin) may be prescribed. If so, bloodwork will need to be checked regularly to ensure you are on the proper dose. If the carotid artery has severe narrowing or blockage, a procedure must be done to open the artery and allow blood flow to the brain, to prevent future stroke:
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