Carotid Artery Disease is Treated at Mercy in Baltimore

The carotid arteries are located on both sides of your neck and provide nutrient-rich blood to the large, front part of your brain. Those arteries can become blocked with plaque (fatty substances and cholesterol deposits), leading to carotid artery disease. People with carotid artery disease are at risk for mini-stroke or stroke because the blood flow to the brain has been limited. Stroke is one of the leading causes of death in the country.

Often there are no symptoms of carotid artery disease. The artery-narrowing plaque builds over time and often without any warning signs until you have a mini-stroke or stroke.  Risk factors include:

• High blood pressure
• Smoking
• Advanced age
• High cholesterol
• Diabetes
• Obesity
• Sedentary lifestyle
• Family history of carotid artery disease
• Coronary artery disease

Stroke symptoms include:

• Sudden severe headache
• Dizziness
• Weakness or numbness on one side of face, body, arm or leg
• Problems with memory or confusion
• Difficulty speaking
• Difficulty in coordination (walking, balance)
• Blurred vision or vision loss

Your primary care physician may listen for blood flow in your carotid arteries. If, however, you’ve had any of the above symptoms, your doctor may also do a diagnostic procedure including:

• Ultrasound - using non-invasive high-frequency sound waves
• Computerized tomography (CT) Angiography - using X-rays and a computer to create cross-sectional images
• Magnet resonance angiography (MRI) - using a magnet to gather information which is translated to a computer which produces high resolution images
• Carotid angiogram - an invasive procedure using dye injected into the carotid arteries which shows real-time blood flow

Reduced blood flow in the carotid arteries requires treatment, depending on the severity of the artery damage or blockage.  Treatments include lifestyle changes (for mild cases), medications and sometimes surgery or stenting (for severe disease and to prevent stroke).  The goal for any treatment option is to prevent a stroke.

Lifestyle changes as treatment options would include:

• Limiting alcohol
• Exercising at least 30 minutes a day
• Maintaining a healthy weight
• Quitting smoking
• Managing chronic conditions like high blood pressure and diabetes
• Getting annual medical care
• Eating a healthy diet

Drug medication is also a treatment option for beginning stages of carotid artery disease. It may include:

• Aspirin
• Plaque reducing medication
• Cholesterol medication
• Blood pressure medication
• A blood thinner

For more severe artery damage or blockage, surgery or stenting may be required to open the artery to increase blood flow. 

• Carotid endarterectomy is a common procedure to surgically remove the plaque buildup to prevent future mini-stroke or full stroke.  The surgeon makes an incision in the neck at the area of the blockage, removes the plaque and diseased areas and stitches the artery back together.
• Carotid stenting is a newer treatment and is less invasive than the endarterectomy. It is beneficial for patients who have other medical conditions that make surgery such as endarterectomy risky. With this procedure, a small puncture is made in the groin area and a catheter is wound to the blocked or compromised area. A small balloon is inflated to open the artery and a small metal mesh tube (stent) is inserted to support the artery. The stent stays permanently in the diseased area.