Carotid Artery Disease (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
In this Article
- What is carotid artery disease?
- What are the causes of carotid artery disease?
- What are the risk factors for carotid artery disease?
- What are the symptoms of carotid artery disease?
- How is carotid artery disease diagnosed?
- What is the treatment for carotid artery disease?
- Surgery for carotid artery disease
- What are the complications of carotid artery disease?
- Can carotid artery disease be prevented?
- What is the prognosis for carotid artery disease?
- Find a local Cardiologist in your town
Surgery for carotid artery disease
Surgery is a potential option for patients with more significant carotid artery disease.
Two options exist, 1) carotid endarterectomy, and 2) carotid angioplasty with stenting.
- In endarterectomy, the surgeon cuts into the artery, removes the plaque buildup and repairs the artery incision.
- In angioplasty and stenting, a vascular surgeon or interventional radiologist inserts a catheter into the artery and inflates a balloon squashing the plaque into the artery wall. A stent or cage is then placed at the site to keep the artery open and prevent renarrowing.
Surgery is recommended for symptomatic patients who have carotid artery narrowing greater than 70%. Surgery may or may not be of benefit for symptomatic patients whose narrowing is between 50% and 69%.
Some patients decide to be screened by ultrasound for carotid artery disease even though they have no symptoms. Surgery is a controversial treatment option for asymptomatic patients who have narrowing greater than 60%.
Surgery is not recommended for patients:
- who have completely blocked arteries because the body may have developed collateral circulation that bypasses the blockage.
- who have already suffered an irreversible stroke because there is no benefit to restoring blood supply to an area of the brain that has already died.
What are the complications of carotid artery disease?
Brain cells cannot be replaced and do not regenerate. Loss of blood supply to the brain will quickly cause brain cells to die. The eventual result of carotid artery disease is transient ischemic attack and stroke. The narrower the artery, the more likely a stroke will occur. However, it is impossible to say with certainty which individual will or will not develop stroke symptoms.
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