The major arteries of the neck, the carotid arteries, supply the brain with blood and extend from your aorta in your chest to the brain inside your skull. Carotid artery disease occurs when these arteries become narrowed or blocked.  Carotid artery disease is a serious health problem because it can cause a stroke.

Carotid Artery Disease and Stroke: Prevention and Treatment

Professor of Surgery Bruce Perler discusses causes, symptoms, risk factors and treatment of carotid artery disease and stroke.

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Symptoms of Carotid Artery Disease

Most patients do not know they have carotid artery disease as it is often asymptomatic (without symptoms).  However, the risk in not having symptoms is that a patient is at risk for a stroke without knowing.   

There are warning symptoms of a stroke called transient ischemic attacks, or TIAs. Symptoms of a TIA usually last for a few minutes to 1 hour and include:

• Weakness, numbness, or a tingling sensation on one side of your body
• Loss of control of the movement of an arm or a leg
• Losing vision in one eye
• Being unable to speak clearly

If you experience a TIA, it could mean that you are at serious risk of a stroke in the near future. You should report TIA symptoms to your vascular surgeon immediately. 

Causes of Carotid Artery Disease

Vascular surgeons are not sure why the arteries begin to harden. Causes may include:

• History of smoking
• High cholesterol
• High blood pressure
• Diabetes
• Family history of hardening of the arteries
• Carotid aneurysm disease
• Fibromuscular dysplasia

What to Expect at Your Medical Exam

Your vascular surgeon will try to determine if you are suffering from PAD as well as the best method of treatment.

1. Your vascular surgeon will ask you questions about your:
   1. general health
   2. medical history
   3. symptoms
2. Your vascular surgeon will conduct a physical examination. You will be asked about family and medical history.  Your vascular surgeon will ask you to describe your symptoms; how often they occur, how often and their location.
3. Your vascular surgeon will listen for sounds of blood flow in your carotid arteries. Your blood pressure will be taken.
4. After the history and exam, if your vascular surgeon suspects you have carotid artery disease, he or she will perform a carotid duplex ultrasound.  This test involves an ultrasound of your neck so your vascular surgeon can measure blood flow as well as arterial and blood vessel structures.  Your vascular surgeon may want to order further tests.

Diagnostic Testing 

There are some common diagnostic tests for carotid artery disease.  They include:

• Duplex Ultrasound
• Magnetic resonance angiography (MRA)
• Computerized tomographic angiography (CTA)
• Angiography

Treatments for Carotid Artery Disease

Based on the results of your physical exam as well as your diagnostic testing, your vascular surgeon will treat your carotid disease.  However, the goal is to also treat the underlying causes of your condition.

Treatments for this condition include lifestyle modifications such as:

1. Smoking cessation
2. Exercise and weight loss,
3. Medication
4.  If necessary, endovascular intervention or surgery. 

Surgery

Surgery may be recommended based on findings during your physical and diagnostic examinations.  Or the lifestyle modifications may not control your condition.

Your vascular surgeon may recommend either of the following surgical procedures to treat your Carotid Artery Disease:

• Carotid endarterectomy or stenting
• Angioplasty and stenting

Physicians who treat this condition