Carotid artery disease

Diagnosis

The doctor will be performing a physical assessment as well as a medical history review, by assessing for signs of bruit, a swooshing sound that can be heard over your neck’s carotid artery showing that the artery is narrowed, as well as assess your speech, memory and strength. Furthermore, these tests may be recommended by the doctor:

  • Ultrasound: Checks blood pressure and flow in the carotid arteries.
  • Computerized Tomography (CT) or Magnetic Resonance Imaging (MRI): Shows any signs of stroke or other unusual signs.
  • CT angiography or Magnetic Resonance (MR) angiography: Shows a more clear view of the carotid arteries in your neck and your brain by injecting a contrast dye to the blood vessel.

Treatment

Treatment of carotid artery disease aims to avoid the occurrence of a stroke. Furthermore, treatment is based on how much plaque is accumulated in the carotid arteries.
Mild to moderate obstruction may be treated by:

  • Changing your lifestyle: Lose weight, stop smoking, reduce salt intake, eat healthy and do regular exercise to decrease atherosclerosis development.
  • Medication: Medication to manage high blood pressure and decrease cholesterol level. Aspirin or other blood-thinners to avoid blood clots may be prescribed by the doctor.

For severely clogged arteries or those that have experienced TIA or stroke, the doctor may suggest to remove the blockage. The following procedures may be performed:

  • Carotid endarterectomy. This is usually the first choice of treatment for carotid artery disease. An incision will be made on your neck to open the damaged blocked artery and take out the plaques. The artery will then be stitched or repaired by grafting.
  • Carotid angioplasty and stenting. A local anesthesia will be used and a catheter with a tiny balloon will be inserted to the blocked artery. The balloon will then be inflated to expand the artery and a stent (a small wire mesh coil) will be placed to keep the artery wide. This procedure is done if the clog is not accessible by carotid endarterectomy or if you have other underlying disease that makes the surgery complicated to be performed.