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St. Vincent's Medical Center, Bridgeport CT

Carotid Artery Surgery

Cardiology Programs & Wellness - St. Vincent's Medical Center, Bridgeport CTCarotid artery disease &
Carotid artery stenosis

Carotid  artery disease, also called carotid artery stenosis, refers to the narrowing of the carotid arteries, which are two large blood vessels that supply oxygenated blood to the large, front part of the brain. That part of the brain is responsible for thinking, speech, personality , sensory and motor functions.

The narrowing is caused by the buildup of fatty substances and cholesterol deposits, known as plaque. A complete blockage is referred to as carotid artery occlusion.

Stroke risk from carotid blockage

Carotid arteries can also develop atherosclerosis or “hardening of the arteries” on the inside of the vessel. Along with the narrowing of the arteries from fatty substances and plaque, this can decrease the flow of blood to the brain and greatly increases the risk of a stroke. See diagnosis, symptoms and treatment of stroke.

A stroke can  occur if the artery becomes extremely narrowed,  a rupture occurs in an artery to the brain resulting from atherosclerosis, a piece of plaque breaks off and travels to the smaller arteries of the brain, or a blood clot forms and blocks the blood vessel.

Risk factors for carotid artery disease are similar to those for other types of heart disease:

• Age
• Smoking
• Hypertension ( high blood pressure)
• High cholesterol or abnormal lipids
• Saturated-fat laden diet
• Insulin Resistance Diabetes
• Obesity
• Sedentary lifestyle
• History of coronary artery disease
• Family History of atherosclerosis or carotid artery disease

Diagnosis

There are often no symptoms of a carotid artery blockage  until you have a transient ischemic attack (TIA) or a stroke.  Plaque can build up slowly over time until a stroke occurs.

As part of a regular physical exam, a physician can listen to the arteries in your neck using a stethoscope. A irregular  sound, called a bruit, indicating an abnormal blood flow, can indicate carotid artery disease. Although somewhat inexact, this test is a simple, safe and inexpensive way to screen for narrowing of the carotid artery or for artheroscleroisis.

Other carotid artery diagnostic tests include:

Carotid Ultrasound (Standard or Doppler):
A noninvasive test using high frequency sound waves to observe the carotid arteries, and detect blockage, narrowing  or presence of plaque or clots. It reveals movement of blood through the blood vessels without ionizing radiation.

Magnetic Resonance Imaging (MRA):
MRA is able to generate high-resolution images of the brain and arteries through the use of radio waves and a powerful magnet. It can often detect even small strokes in the brain.

Computerized Tomography Angiography (CTA):
CTA produces cross sectional images of the carotid arteries and the brain through the use of x-ray and computer technology, revealing areas of damage. 

Cerebral Angiography (carotid angiogram):
This procedure provides the best information on the status of the carotids. Cerebral angiography allows the doctor to see narrowing or blockages on a screen as contrast dye is injected into the carotid arteries. There is a small risk of serious complications.

Learn more about our Radiation tools and treatment options >>

If you have been diagnosed with carotid artery disease

Keep it from progressing and adopt the following lifestyle changes:

However, if your symptoms do not improve by following these guidelines and through the medication therapy listed above, St. Vincent’s Regional Heart & Vascular Center offers both surgical and non-surgical treatment for carotid and peripheral vascular obstructions.

Treatment

Doctors recommend the following to treat carotid artery disease:

  • Healthy lifestyle habits
  • Medications: anti-platelet medications such as aspirin to decrease the risk of blood clots and stroke
  • Procedure to improve blood flow

Ignoring the problem will not make it go away. Again, if you have been diagnosed with carotid artery disease, in order to keep it from progressing, you should adopt the following lifestyle changes and have your progress checked often:

However, if your symptoms do not improve by following these guidelines and through the medication therapy listed above, St. Vincent’s Regional Heart & Vascular Center offers both surgical and non-surgical treatment for carotid and peripheral vascular obstructions.

Advanced treatment

If a blockage has narrowed the carotid artery dramatically, there are several treatment options available.

Carotid endarterectomy (CEA):

The traditional procedure for those with atherosclerosis in the carotids or who have suffered TIAs or mild strokes, this procedure is performed under general anesthesia. After making an incision in the neck, the surgeon identifies the blocked artery and removes the plaque material and diseased sections of the artery. The surgeon then sews the artery together and proper blood flow is restored. The decision to undergo CEA is contingent upon age of patient, the number and degree of blockages and whether the patient has suffered a stroke or TIA.

Carotid Artery Stenting (CAS):

A new procedure, CAS has generated some controversy as to its effectiveness in preventing strokes related to carotid artery disease. It is less invasive than CEA and is performed in a catheterization laboratory.  After a catheter is threaded through a small puncture in the groin to the section where the narrowing occurs, a balloon tip opens the artery. Then a permanent stent or wire-mesh tube is put into position to hold the artery open.  

St. Vincent's Medicial Center: Surgical expertise when you need it most.

Contact us

To find a St. Vincent’s physician who can discuss your health concerns or those of a loved one, please click on our FIND A DOCTOR tool and search by specialty, practice, location or keyword. We’re here to help you locate the medical expert you need.

To speak with a St. Vincent's Care Line representative, call (877) 255-7847

To speak with somone at the front desk of the Medical Center, please call (203) 576-6000

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