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Click to enlarge. Patient Info

Essam El-Kady, chief of Vascular Surgery at the El Maadi Armed Forces Hospital in Cairo, Egypt operating with Dr. Brantigan. Click to enlarge.

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Carotid Disease 

The carotid arteries are located in the neck. Blood flows through the carotid artery supplying the brain and face with oxygen and nutrients. Significant narrowing or complete blockage of blood to the brain is a serious situation. And may lead to a debilitating stroke.

Symptoms

  • Bruit (brew-ee) - This is an abnormal sound caused by constricted blood flow in the artery. Frequently, a physician will notice this sound during a routine examination by listening to the sides of the neck with a stethoscope.
  • Visual disturbance in one eye only
  • Slurred speech
  • Weakness of one side of the body. For example, left arm weakness or left leg weakness.
  • These symptoms may last from seconds to hours to a lifetime.

Diagnosis

1. A complete examination - This is a painless and simple test by your doctor.

2. Carotid ultrasound testing - This is a painless, non-invasive view of the arteries which allows the physician to view and measure any disease in the artery. This ultrasound is similar to the type used in obstetrics.

3. Carotid Artery Arteriogram - This test is sometimes needed to supplement ultrasound studies. Dye is injected into the artery and x-rays are taken. This demonstrates the diseased areas. This test is done in the hospital by specialized physicians (see arteriograms)

Treatment

Medical Management

When the disease is mild and there are no symptoms (less than 60% of the artery is blocked) patients are instructed to have ultrasound testing every 6 to 12 months. Sometimes the narrowing progresses and requires surgery. Other times, the plaque remains stable and requires no treatment. Controlling risk factors is important. Stop smoking, control weight and eat low fat foods.

Surgical Management

The patient and physician discuss the risks and benefits of surgery. The procedure is called Carotid Endarterectomy (ka-ro-tid endarter-ekt-o-mee).

The length of surgery is approximately 2 hours.

The incision is located at the side of the neck and is about four inches long. The artery is opened and the plaque is removed. The artery is stitched closed.

Hospital stay is usually 2 days.

Continued follow-ups are required by using ultrasound. Occasionally, the plaque buildup will reoccur or blockage will occur on opposite side.

Most patients experience little post op pain during recovery.


2003-2004 Dr. Charles Brantigan,  Vascular Surgery Practice
2253 Downing Street, Denver, CO 80205
303.830.8822 fax: 303.830.7068 or 800.992.4676  inquiries@drbrantigan.com

Last Updated: 07/15/2004