Carotid Artery Disease Treatment

The purpose of treatment for carotid artery disease is to prevent a stroke. But the type of treatment you receive depends on several factors, including the extent of the blockage, the signs and symptoms you're experiencing, and other medical conditions you may have.

The carotid arteries are a pair of blood vessels that deliver blood to your brain and head. When these blood vessels become clogged with fatty deposits (plaque) that restrict blood flow -- a condition known as carotid artery disease -- your risk of stroke increases. Most strokes associated with carotid artery disease are caused by small clots that form in the area of the restricted blood flow and travel to the brain.

With a 50-percent blockage, and if you haven't had any signs or symptoms of a stroke, I would generally recommend that your condition be treated with lifestyle changes and medication.

Eating healthy foods, exercising, losing weight and, in some cases, lowering the amount of sodium in your diet, may help slow the progression of carotid artery blockage (stenosis). Cigarette smoking is a risk factor for carotid artery disease and stroke. If you use tobacco, you should permanently stop.

Effectively managing chronic medical conditions also is important. High blood pressure (hypertension) is a key risk factor for stroke among people with carotid artery disease. Bringing your blood pressure down to approximately 120 over 70 mmHg can reduce your risk of stroke significantly. Controlling your blood sugar levels if you have diabetes and lowering your cholesterol levels with diet, exercise and, if necessary, a statin drug -- if you have high cholesterol -- may reduce your stroke risk, as well.

Taking an aspirin every day is often part of treatment for carotid artery disease, too. Aspirin is an effective blood-thinning medication that can help prevent blood clots from forming in the narrowed carotid arteries. If you can't take aspirin, your doctor can prescribe another drug that will have a similar effect.

You don't mention if you've had signs or symptoms of a stroke, such as sudden weakness, numbness or paralysis on one side of your body affecting the face, arm or leg; slurred speech; or sudden blindness in one eye. If you experience any of these, seek immediate medical attention.

Even if they last for only a short time, tell your doctor. Signs and symptoms of a stroke that last less than 24 hours, and after which you feel normal, may be the result of a temporary shortage of blood to part of your brain (transient ischemic attack or TIA). Having a TIA significantly increases your risk of having a stroke.

For people who have carotid artery disease and experience TIA or other stroke signs and symptoms, or for those who have a higher level of blockage than you do, such as 70 percent or more, lifestyle changes and medication usually aren't enough. Treatment in these situations typically involves a procedure to remove the blockage. A carotid endarterectomy is the most common operation. During this surgery, performed under general anesthesia, a surgeon opens the carotid artery and removes the plaque.

In some cases, a carotid endarterectomy may not be an option. The location of the blockage may be difficult to reach directly. Or, a patient may have a condition that makes surgery too risky, such as previous neck radiation or neck surgery, severe heart or lung disease, or kidney failure.
In these situations, carotid angioplasty and stenting may be appropriate. This procedure involves inflating a tiny balloon at the end of a long hollow tube (catheter) within the blocked artery, then inserting a wire-mesh metal stent into the artery to keep it open.

These are the general treatment guidelines for carotid artery disease but they don't apply in all situations. Factors such as your age, past medical history and underlying medical conditions also need to be taken into consideration. Talk to your doctor about a treatment plan that's best for you.

Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.