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Carotid artery disease

Avoiding strokes through advanced treatment

If you have recently been diagnosed with carotid artery disease, you need treatment from a team of heart and vascular experts that are committed to reducing your chance of a stroke. In addition to helping you make the necessary lifestyle changes, the team at Novant Health can also provide a variety of treatment options to ensure you continue living a happy and healthy life.

What is carotid artery disease?

The carotid arteries supply blood to the large, front part of the brain where thinking, speech, personality, sensory, and motor functions reside. This disease occurs when your carotid arteries become narrow – usually caused by the buildup of cholesterol, fat and other substances traveling through the bloodstream. This buildup creates a blockage that prevents your brain from getting the oxygen it needs from your blood flow.

What are the symptoms?

You may not have 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. A TIA occurs when a blood clot briefly blocks an artery that supplies blood to the brain. The following symptoms of a TIA, which are temporary and may last a few minutes or a few hours, can occur alone or in combination:

  • Sudden loss of vision or blurred vision in one or both eyes
  • Weakness and/or numbness on one side of the face, in one arm or leg or on one side of the body
  • Slurred speech, difficulty talking or understanding what others are saying
  • Loss of coordination
  • Dizziness or confusion
  • Difficulty swallowing
How is carotid artery disease diagnosed?

There may not be any symptoms of carotid artery disease. If you are at risk, it is important to have regular physical exams. Diagnostic tests include:

    Podcast: Carotid artery duplex scan

  • Carotid duplex ultrasound – An imaging procedure that uses high-frequency sound waves to view the carotid arteries to determine if there is narrowing. This is the most common test used to evaluate for the presence of carotid artery diseases.
  • Carotid angiography (carotid angiogram, carotid arteriogram, carotid angio) – During this invasive imaging procedure, a catheter (a thin flexible tube) is inserted into a blood vessel in your arm or leg and guided to the carotid arteries with the aid of a special X-ray machine. Contrast dye is injected through the catheter while X-rays of the carotid arteries are taken. This test may be performed to evaluate or confirm the presence of narrowing or blockage in your carotid arteries, determine the risk for future stroke and evaluate your need for future treatment, such as carotid stenting or surgery.
  • Computerized tomography (CT scan)A CT scan of the brain may be performed if a stroke or TIA is suspected to have already occurred. During a CT scan, X-rays pass through the body and are detected by the scanner, which produces three-dimensional (3D) images on a computer screen. Depending on the type of scan you need, a contrast material might be injected intravenously (into a vein) so the radiologist can see the body structures on the CT image. This test may reveal areas of damage in the brain.
  • Computed tomography angiogram (CTA) – A test that uses advanced CT technology, along with intravenous (IV) contrast material (dye), to obtain high-resolution, 3D pictures of the carotid arteries. CTA images enable physicians to determine the degree of stenosis in the carotid and vertebral arteries as well as the blood vessels in the brain.
Lifestyle changes you will need to make

One of the most effective ways to fight this disease is to make changes to your lifestyle. We recommend implementing the following changes in your everyday life:

  • Quit smoking and using tobacco products
  • Control high blood pressure, cholesterol, diabetes and heart disease
  • Have regular checkups with your doctor
  • Have your doctor check your lipid profile
  • Eat foods low in saturated fats, cholesterol and sodium
  • Achieve and maintain a desirable weight
  • Exercise regularly
  • Limit the amount of alcohol you drink
Medications

Your doctor might ask you to start taking a daily dose of aspirin or another blood-thinning medication to reduce the risk of blood clots. Other medications like angiotensin-converting enzyme (ACE) inhibitors or calcium channel blockers may be recommended to control your blood pressure.

Treatments and procedures

To avoid further complications with this disease, your doctor may recommend one of the following treatments:

    Podcast: Carotid endarterectomy / carotid angioplasty with stenting

  • Carotid endarterectomy – The plaque blocking the artery will be removed by a surgeon to restore normal blood flow to the brain.
  • Carotid stenting – A small stent will be inserted inside the artery to restore normal blood flow to the brain and help prevent future blockage.
  • Carotid angioplasty – A small balloon catheter will be inserted inside the artery and inflated to open it up. Once the artery is opened back up, debris will be gathered from the artery and a stent will be inserted to restore normal blood flow and help prevent future blockage.

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