Severe narrowing of the carotid arteries can lead to stroke and death. The carotid
arteries are the main blood supply to the brain. Narrowing of the arteries with plaque
is the cause of stroke in about half the patients with a stroke. We all probably
know someone who’s suffered from a stroke and strokes can even lead to death. Large
studies have shown that for patients with severe narrowing of the carotid arteries,
surgery is superior to medicines alone in preventing stroke.
Fortunately, the diagnosis of carotid artery narrowing can usually be done painlessly
with an ultrasound. Our vascular lab performs these studies and is nationally certified.
Carotid artery narrowing may occur without symptoms until you have a stroke. Your
physician may hear an abnormal sound when they are listening to your neck with a
stethoscope. This is called a bruit (brew-ee). If you have had an episode where you
briefly lost vision in one eye, had weakness on one side of your body, had slurred
speech or weren’t able to get your words out, your doctor will likely order an ultrasound.
Your physician may also order an ultrasound if you have risk factors for stroke such
as tobacco smoking, heart disease, hypertension, aneurysm, or prior vascular bypass.
Mild carotid narrowing without any symptoms can be followed by ultrasounds every
6 to 12 months. Controlling the risk factors for atherosclerosis and stroke can sometimes
slow or stop the progression of atherosclerosis. This includes stopping smoking,
regular exercise, control blood pressure, control diabetes, treat elevated cholesterol,
and maintain a normal weight. Your physician will likely recommend an aspirin a day
or another antiplatelet medication.
More severe narrowing, or patients with symptoms felt to be due to narrowing, will
be evaluated for an operation called carotid endarterectomy. In this operation, an
incision will be made on the side of the neck. The artery is opened and the plaque
removed. The opening in the artery is then stitched closed. The operation takes about
2 hours and most patients go home the next day.