• Carotid Artery Disease

     
     
     
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    All of the organs and tissues in your body need a steady stream of oxygenated blood to function. If blood flow to your heart is disrupted, you may have a heart attack. Similarly, if your brain does not receive the proper amount of blood, you may have a stroke. Stroke is the third highest cause of death in the United States, behind only heart disease and cancer, and is a leading cause of long-term disability. According to the American Heart Association, each year nearly 800,000 people in the United States will experience a stroke. Many strokes are the result of carotid artery disease, a narrowing and thickening, or “hardening,” of the arteries that carry blood to the brain.

    The carotid arteries are two large blood vessels located toward the front of the neck. Blood that travels from the heart passes through a large artery called the aorta and then through the carotid arteries to the brain. Each of these arteries splits into two separate arteries near the top of the neck to form the left and right internal and external carotid arteries. The larger of these two branched arteries, called the internal carotid artery, delivers oxygenated blood to portions of your brain responsible for cognition, speaking, and motor skills.

    Narrowing of the carotid arteries is usually caused by build-up of a substance called plaque, which is made up of cholesterol, calcium, fatty substances, and other materials found in the bloodstream. When arteries are narrowed by plaque deposits, this is called atherosclerosis.

    You may not know you have carotid artery disease until something goes wrong. Often a stroke victim will have no warning symptoms. However, some patients do experience warning signs in the form of a transient ischemic attack (TIA), sometimes referred to as a “mini-stroke.”

    TIA symptoms, as for a stroke, include numbness or paralysis (usually on one side of the body), difficulty speaking or understanding, and temporarily dimmed or blurred vision. These symptoms resolve within a few minutes or hours, but they are your body's warning to contact your doctor right away.

    If you are diagnosed with carotid artery disease, more treatment options are available now than ever before. Advances in treatment for heart disease are successfully being applied to carotid artery disease. Your physician may prescribe treatments as simple as lifestyle changes or medication.

    For patients with a serious blockage in a carotid artery, a physician may recommend reopening the artery through a procedure called carotid angioplasty. During angioplasty, a thin tube called a catheter is inserted into the artery and a small balloon opens to expand the blocked artery. Your physician will also usually place a stent, a tiny mesh tube, in the artery to help keep it open. Alternately, a surgical procedure called carotid endarterectomy may be indicated. During this surgery, an incision is made in the carotid artery to remove the blockage. A care team determined by the specifics of your diagnosis, including doctors, nurses, specialists, and lifestyle coaches, will be there to assist you through treatment, recovery, and prevention.

    To learn more about the warning signs for stroke, click here.

  • More About Carotid Artery Disease

     
     
     
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    Causes of Carotid Artery Disease

    As we age, cholesterol and fatty substances build up in our arteries, causing the arteries to narrow and increasing our risk for cardiovascular disease, including both carotid artery disease and coronary artery (heart) disease.

    Diagnosing Carotid Artery Disease

    Physicians have a number of techniques available to them for diagnosing disease in the carotid arteries, which carry blood to your brain. Your doctor will first take your medical history and will then give you a physical exam. He or she may hold a stethoscope over the carotid arteries in your neck to listen for a whooshing sound, called a bruit, which can indicate narrowing of the arteries. Your medical history or discovery of a bruit may prompt your physician to refer you for diagnostic tests.

    Jim Sparacino – Knowing the options for stroke prevention has him singing a new tune.

    While moving band equipment prior to one of his performances, 53-year-old Jim Sparacino began to feel light-headed, a feeling he had become accustomed to over the past few months. A bystander thought Jim was having a heart attack, but his heart was fine. Instead, Jim was suffering from carotid artery disease, which can lead to a stroke. Working with his doctors, Jim explored his treatment options, keeping in mind his need to protect his vocal cords. Read his story and learn which treatment was right for him.

    Lifestyle Changes for People with Carotid Artery Disease

    Once blood flow has been restored, your work-and that of your care team-is not over. Procedures such as carotid angioplasty and stenting or endarterectomy can address serious blockages in the arteries, but they do not control other risk factors or remove plaque build-up throughout all arteries in the body. That's when the focus of treatment turns from procedures to medication and lifestyle changes.

    Symptoms of Carotid Artery Disease

    Carotid artery disease is a gradual process that slowly blocks the artery, and therefore often does not present any warning signs until the artery is almost totally closed. A stroke or a "mini-stroke" (transient ischemic attack) might be your first indicator that your carotid arteries are not healthy.

    Treatment Options for Carotid Artery Disease

    For the last 50 years, a diagnosis of narrowing, or stenosis, in the carotid arteries would most likely result in a recommendation of surgery to prevent stroke. Surgery to remove plaque from the carotid arteries, called a carotid endarterectomy, is still a viable and life-saving procedure that is performed today. However, now more than ever, physicians have latitude to assess the degree of narrowing in the arteries, the age of the patient, and other factors to determine the best course of treatment.

    Your Care Team During Carotid Endarterectomy

    If treating your blockages in the carotid arteries requires that you undergo a surgical procedure, called a carotid endarterectomy, to remove plaque, your cardiologist will refer you to a vascular surgeon. A vascular surgeon has served a five-year residency in general surgery and has had two additional years of training in vascular surgery.