Endovascular Services

Carotid Artery Disease (CAD)

A build up of plaque within the carotid arteries that reduces blood flow to the brain is a condition called Carotid Artery Disease (CAD). The most common cause of CAD is atherosclerosis, in which fatty deposits along the arteries' interior walls results in restricted blood flow to the brain. This blockage increases risk of stroke

CAD Commonly occurs in:

  • Age
    • Men under age 75 have a greater risk than women.
    • Women over age 75 are at a greater risk.
  • Diabetes
  • Family history of Coronary Artery Disease
  • Hypertension (high blood pressure)
  • Lack of physical exercise
  • Obesity
  • Smoking

Signs of Carotid Artery Disease:
There are often no symptoms of CAD until an individual has a Transient Ischemic Attack ( TIA) or a stroke.

Transient Ischemic Attack (TIA)
Symptoms are similar to stroke, but only last for a few minutes or hours and then resolve:

  • Slurred or garbled speech or difficulty understanding others
  • Sudden weakness, numbness, or paralysis of the face, arm or leg, typically on one side of the body
  • Temporary loss of vision or graying out of vision in one eye

Stroke
An individual who has had a stroke may present with:

  • Weakness, tingling, numbness in one side of the face, body, arm or leg
  • Difficulty speaking
  • Sudden lack of coordination, loss of balance, difficulty walking
  • Sudden loss of vision (blurred or difficulty seeing in one/both eyes)
  • Problems with memory

Diagnosis:

Most patients with carotid disease have no symptoms. Some patients present with signs of TIA or stroke (see above).

On physical examination your doctor may find a "bruit", or a noise heard with a stethoscope over the carotid artery caused by turbulent blood flow.

Diagnostic tests to detect carotid disease include:

  • Duplex ultrasound of the carotid arteries
  • Computerized Tomography (CT) Angiography
  • Magnetic Resonance Angiography (MRA)
  • Cerebral Angiography (Carotid Angiogram)

Treatment:

Medical treatment involves lifestyle modifications in the form of:

  • tobacco cessation
  • exercise
  • diet changes
  • drug therapy (antiplatelet drugs such as aspirin or Plavix)

Carotid Endartecrectomy: Surgically removes the plaque that has built up within the artery through a neck incision. This usually involves an overnight stay in the hospital.

Carotid Artery Stenting:Involves opening the artery with a balloon and placing a stent (metal scaffolding) to hold it open. This is done through a small puncture hole in the groin and usually involves an overnight stay as well. Carotid artery stenting is only done in select cases.