Carotid Artery Disease

Carotid artery disease, or carotid stenosis, is the narrowing of the carotid arteries caused by a buildup of material called plaque. Carotid artery disease is responsible for about a third of all strokes, which can occur when small clots form in the carotid arteries, then break off and travel to the brain. The expert vascular surgeons of ARA Health are proud to offer surgical removal of plaque buildup to treat carotid artery disease.

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ABOUT CAROTID ARTERY DISEASE

The carotid arteries are the main arteries in the neck that supply blood to the brain. The plaque that leads to carotid artery disease is made up of deposits of cholesterol and other fatty substances. Over time, this plaque buildup causes the arteries to narrow, which puts patients at risk for a stroke. People over the age of 65 with a history of smoking, high blood pressure, high cholesterol, diabetes, or heart disease have a higher risk of developing carotid artery disease. Most patients with carotid artery disease experience no symptoms. In fact, for many the first sign of disease is a stroke, marked by weakness or numbness on one side of the body, slurred speech, or facial drooping. 

DIAGNOSIS

Carotid artery disease typically is found in a routine physical examination or after a stroke has occurred. In some cases, diagnosis stems from eye examination, when an ophthalmologist detects plaque in the artery that supplies the retina. A noninvasive carotid artery duplex scan uses ultrasound to determine whether the artery is narrowing and estimate severity. Computerized tomography (CT), magnetic resonance angiography (MRA), or angiogram may also be used to assess the arteries.

TREATMENTS

Medications

Medications to lower cholesterol and blood pressure can help to slow the progress of carotid artery disease, as well as quitting smoking. However, if imaging finds the artery to be more than 60% blocked, experts may recommend surgery.

Carotid Endarterectomy

Endarterectomy is a surgical procedure to remove plaque buildup from the carotid arteries. Our vascular surgeons use this technique to separate the plaque from the arterial wall, improving blood flow and reducing the risk for stroke and heart attack. 

You have questions. We have answers.

Below you'll find answers to some of the questions we are commonly asked by patients. Please contact our ARA Cares Coordinator at (828) 436-5500 with any additional questions or concerns.

How do I prepare for a carotid endarterectomy?
Your surgeon may order imaging studies before your carotid endarterectomy or may ask to review previous imaging studies. It's important to provide your doctor with a comprehensive list of medications, both prescriptions and over-counter-medications, as well as any supplements or herbs you take regularly. You will be instructed on which medications are safe to continue and which should be stopped before your procedure. It is especially important to advise your doctor if you are taking aspirin and share any medical reasons why you are taking it. Other instructions such as withholding food or liquids and what time to arrive will be provided closer to your procedure date.
What happens during a carotid endarterectomy?
During a carotid endarterectomy, you will be given either general anesthesia or a local anesthetic. An incision is made at the front of your neck, and the plaque is removed from your artery. The artery is repaired by stitching in a natural graft (formed from a piece of vein from elsewhere in your body) or a woven patch. The incision is closed. A carotid endarterectomy is performed in a sterile surgical suite or standard operating room. You may go home the same day or stay 1–2 nights after the procedure depending on your medical condition.  You receive a local anesthetic or general anesthesia.  Your vascular surgeon makes an incision at the front of your neck.  After removing the plaque from the artery your vascular surgeon repairs the artery by stitching in a natural graft (formed from a piece of vein from elsewhere in your body) or a woven patch.  The incision is closed.
What happens during a carotid endarterectomy?
During a carotid endarterectomy, you will be given either general anesthesia or a local anesthetic. An incision is made at the front of your neck, and the plaque is removed from your artery. The artery is repaired by stitching in either a woven patch or a natural graft, which is created using part of a vein from elsewhere in your body. Finally, the incision is closed. Some patients are able to go home the same day, while others require a 1-2 night hospital say.