Carotid Artery Disease

All of our blood vessels are subject to disease. Advancing age, high cholesterol, high blood pressure and smoking can result in the formation of fat deposits inside the wall of the arteries, which can develop into obstructions of plaque, narrowing and hardening the arteries (atherosclerosis). Multiple risk factors can contribute to this process, including:

• Gender (Men have a greater risk)
• Family history of the disease
• Diabetes
• Elevated cholesterol levels
• Smoking

Unfortunately, carotid artery disease doesn’t often cause symptoms. As a result, many patients are first diagnosed when carotid artery disease at a more advanced stage, or even once they experience a stroke.

Our goal is to detect these issues and treat the problem before a stroke can occur.  If you have risk factors for carotid artery disease, the best first step is to book an appointment with one of the vascular surgeons at Georgia Heart Institute to assess your risk and determine if diagnostics are necessary.

Diagnostic tests may include:

• Carotid duplex/ultrasound scan – This non-invasive test is performed by placing ultrasound gel and an ultrasound probe on the neck and transmitting sound waves onto the carotid artery. Similar to sonar on a boat, the sound waves bounce back, giving an image of the artery and determining the speed of the blood flowing in the vessel. The velocity of the blood can indicate the degree of narrowing, or stenosis, in the artery.
• CT angiography – We also can use advanced, non-invasive imaging technologies like CT angiography to capture more detailed pictures of your arteries, providing valuable information and allowing us to determine the safest and most definitive treatment options for each patient.

With any major health condition, treatment begins with simple changes in everyday behaviors to limit key risk factors. While some of these factors, like age and family history, cannot be changed, it’s important to address the risk factors that are modifiable. This includes:

• If you smoke – stop! Not only does it put you at greater risk for cancer and lung disease, smoking also will cause increased plaque build-up and artery narrowing faster.
• Elevated blood sugars caused by diabetes can also lead to rapid progression of disease, especially in very small arteries.
• Maintaining healthy blood pressure and cholesterol levels through diet changes or medication is important.
• Anti-blood clotting medications like aspirin and Plavix are commonly prescribed.

This minimally-invasive procedure performed in our state-of-the-art Endovascular Suite utilizes a specialized catheter containing a stent, which is inserted through the leg and directed through the blood vessel to the diseased section of the artery. Once in place, it is deployed off the catheter and into the carotid artery, opening the segment of plaque build-up and restoring blood flow within the artery.

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The most common treatment for a blocked carotid artery is a carotid endarterectomy. This open procedure directly removes the plaque from inside the artery in order to restore normal blood flow to the brain. Making an incision on the neck and directly exposing the artery, the surgeon opens the artery, cleans out the plaque from the inside, and sews the artery closed with a special patch. Most people require a one-night hospital stay with close monitoring and can resume normal activities in a few weeks.