The carotid arteries are the major arteries in your neck that supply blood to the brain. Carotid artery disease occurs when these arteries become narrowed or blocked.

Arteries are normally smooth and unobstructed on the inside. With aging, a sticky substance called plaque can build up on the walls of the artery. As more plaque builds up, the arteries narrow and stiffen resulting in atherosclerosis, or hardening of the arteries. Eventually, enough plaque will build up to reduce or disturb the flow of blood through the carotid arteries. Carotid artery disease is a serious health problem and may lead to a mini stroke (TIA), or major stroke (CVA).

Warning Signs of a Stroke:

• Sudden weakness, numbness, or paralysis of the face, arm, or leg, especially if on only one side of the body
• Loss of speech or trouble talking or understanding language
• Sudden loss of vision, particularly if in only one eye
• Sudden, severe headache with no apparent cause
• Unexplained dizziness, loss of balance, or coordination (especially when associated with any of the above symptoms
• Transient ischemic attacks (TIAs) Ministrokes, known as transient ischemic attacks, precede about one third of all strokes and can occur hours, days, weeks, or even months before a stroke. TIAs happen when the blood supply to the brain is temporarily interrupted. The symptoms usually occur rapidly and disappear within a short time. For instance, if you experience a sudden loss of vision, or weakness in an arm or leg that disappears, you might be having a TIA. Because TIAs are temporary and the body soon returns to normal, many people ignore these attacks. However, ignoring TIAs is dangerous because they are often early warning signs of a more serious and debilitating stroke in the future
• Amaurosis Fugax
• Symptoms include the sudden loss of vision in one eye. This usually only lasts seconds but may last several minutes. Some patients describe the loss of vision as a gray or black shade coming down over their eye.

Carotid Stenting is a newly developed minimally invasive procedure to treat carotid artery disease is angioplasty and stenting. Angioplasty and stenting is usually performed using a local anesthetic. To perform this procedure, your vascular surgeon will insert a long, thin tube called a catheter through a small puncture site over a groin artery and guide it through the blood vessels to the carotid artery. The catheter carries a tiny balloon that inflates and deflates, flattening the plaque against the walls of the artery. The physician then places a tiny metal-mesh tube called a stent in the artery to hold it open. Your hospital stay after angioplasty and stenting is approximately the same as with endarterectomy. For patients who have medical conditions that increase the risk of carotid endarterectomy, angioplasty and stenting may be a good alternative. It has been approved for patients considered to be at high risk for the surgical endarterectomy procedure.

Carotid Endarterectomy is the surgical procedure to remove the plaque that is blocking the carotid artery. During this procedure, the surgeon makes an incision in the neck and then removes the plaque contained in the inner lining of the carotid artery leaving the inner lining of the artery smooth and wide open. In general, most patients are admitted on the day of their operation. The majority of carotid endarterectomies are performed utilizing general anesthesia. The operation takes approximately two hours. An incision will be make in the neck overlying the artery. An incision will then be made in the artery with removal of accumulation of plaque (atherosclerosis) from the artery. A synthetic patch material (Hemashield) is then utilized to patch and enlarge the artery and to help prevent re-narrowing.

Post-operative Recovery:  Following the operation, all patients require an overnight stay in the intensive care unit for special monitoring. Most patients are discharged to home the day following the procedure. You may have some steri-strips overlying your incision. You may get in the shower daily and wash your incisions. The steri-strips will curl up after several days, and you can gently remove them. Some patients may experience difficulty with poor appetite or easy fatigue. This is generally a consequence of the anesthesia and should resolve with time. In general, we advise those patients to take frequent naps as needed and encourage you to eat what appeals to you. We are not that concerned with following a strict low fat, low cholesterol diet at this time. You need calories to heal from the operation.

Prevention:  Fortunately, you may be able to prevent or slow carotid artery disease. Quitting smoking is the most important change you can make to avoid this disease. Other ways to prevent carotid artery disease include:

• Exercising regularly
• Eating a healthy diet
• Maintaining a healthy weight