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. |
