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Carotid Artery Disease
Carotid artery disease occurs when the blood vessels that deliver blood to your head and brain (carotid arteries) become damaged or diseased. Like coronary artery disease, the damage done to the blood vessels is often caused by cholesterol-containing deposits (plaques) that clog or block the carotid arteries. The blockage increases your risk of stroke, a medical emergency that occurs when the blood supply to the brain is interrupted or seriously reduced.
A stroke deprives your brain of oxygen. Within minutes, brain cells begin to die. Stroke is the most common cause of death and the leading cause of permanent disability in the U.S.
Carotid artery disease develops slowly. The first sign that you have the condition may be a stroke or transient ischemic attack (TIA). A TIA is a temporary shortage of blood flow to your brain.
The goal in treating carotid artery disease is to prevent stroke. Specific treatments depend on the extent of blockage in your carotid arteries. Treatment of carotid artery disease usually involves a combination of lifestyle changes, medication and sometimes surgery.
If blockage is mild to moderate, your doctor may recommend:
- Lifestyle changes to slow the progression of damage to the arteries. Recommendations may include quitting smoking, losing weight, eating healthy foods, reducing salt, and exercising regularly.
- Medication to control blood pressure or lower cholesterol. Your doctor may also recommend taking a daily aspirin or other blood-thinning medication to prevent blood clots.
Procedures & surgery
If blockage is severe, or if you've already had a TIA or stroke, your doctor may recommend removing the blockage from the artery. The options include:
Carotid endarterectomy is the most common treatment for severe carotid artery disease. During the procedure, our surgeons make a cut along the front of your neck and open your carotid artery. They then remove the plaque deposits that are causing the clog or blockage. The surgeons then repair the artery with stitches or a patch made with a vein or artificial material.
Transcarotid artery revascularization (TCAR) is a minimally invasive procedure that helps treat carotid artery disease and helps prevent future strokes. During TCAR, our surgeons make a small incision at the neckline to access the carotid artery. They then place a tube directly into the artery and connect it to a transcarotid neuro-protection system (NPS). The NPS system reverses your blood flow away from the brain to protect against plaque or debris that may come loose during the procedure. The plaque and debris is collected in the device filter before returning the blood to a vessel in the leg. The surgeons then place a stent (expandable mesh tube) at the site of the blockage for long-term stabilization of the plaque in the carotid artery and stroke prevention. After the stent is placed, the blood flow reversal is turned off and blood resumes to flow in its normal direction.
Because the procedure is minimally invasive, TCAR is well suited for patients who are at high-risk of surgical complications due to age or anatomical issues.