Carotid Artery Disease

What is Carotid Artery Disease?

Carotid artery disease occurs when there is a build-up of plaque (a process called atherosclerosis) in the carotid arteries. Located on either side of the neck, the carotid arteries supply blood and oxygen to the brain. Carotid artery disease is a major risk factor for both strokes and mini-strokes, also known as transient ischemic attacks (TIA).

What causes it?

Atherosclerosis is a medical condition in which plaque (calcium deposits, cholesterol and other debris) accumulates on the inside of the artery walls. Over time, a build-up of plaque on the carotid arteries can be very damaging to the brain and the eyes. The plaque can harden the arteries and narrow the space for blood flow, which decreases the amount of oxygen reaching the cells. Pieces of plaque (emboli) can also break off and block nearby arteries.

What are the symptoms?

Carotid artery disease typically has no symptoms. The first sign may be a TIA or mini stroke lasting a few minutes to 24 hours. Symptoms of a TIA include:

  • Sudden weakness or numbness of the arm, leg or face on one side of the body
  • Slurred speech
  • Loss of vision in one eye
  • Difficulty talking or understanding speech

If you experience one or more of the above warning signs, call 911 for immediate medical treatment.

What are the risk factors?

  • Atherosclerosis
  • High blood pressure
  • High cholesterol
  • Family history
  • Smoking
  • Diabetes
  • Obesity
  • Genetic factors
  • Older age

How is it diagnosed?

During a physical exam, your physician may be able to use a stethoscope to hear an abnormal rushing sound in the neck, which could indicate a narrowing of one or more carotid arteries. To confirm the diagnosis, you will undergo an ultrasound of the carotid arteries, which can identify blockage and evaluate the blood flow. Magnetic resonance imaging (MRI) and carotid angiography, a special type of X-ray in which contrast dye is injected into your veins, can also confirm carotid artery disease.

How is it treated?

In mild cases, Dr. Lam may suggest lifestyle changes, such as smoking cessation or diet changes, to prevent the progression of the disease. In moderate cases, Dr. Lam may prescribe medications in addition to the lifestyle changes mentioned above.

However, in more serious cases, surgery may be recommended to remove the blockage and reduce the risk of stroke. Dr. Lam offers two procedures in Dallas to treat carotid artery disease: carotid endarterectomy and the minimally invasive procedure called carotid artery stenting or endovascular repair.

Carotid endarterectomy

Carotid endarterectomy is the treatment most recommended by Dr. Lam when a patient is presenting severe carotid artery disease – with or without symptoms of impending stroke. During the procedure, the blockage in the carotid artery is removed via an incision in the neck. This procedure has a high success rate and typically only requires a one-night hospital stay.

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Endovascular repair

Endovascular repair, also known as carotid artery stenting, is recommended for patients whom Dr. Lam considers a high risk for surgery, have had previous neck surgery or have undergone radiation therapy. It is a minimally invasive procedure where a catheter is inserted in the femoral artery to compress the blockage and place a stent to strengthen the artery.

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