Carotid Artery Stenosis
Making Surgery Less Painful©
Carotid Stenosis
is a narrowing or constriction of the
inner wall, or lumen, of the carotid artery. The carotid artery is the
large artery whose pulse can be felt on both sides of the neck under the
jaw. This artery starts from the aorta as the common carotid artery, and at
the throat it forks into the internal carotid artery and the external
carotid artery. The internal carotid artery supplies the brain, and the
external carotid artery supplies the face. These two artery branches are a
common site for atherosclerosis, an inflammatory buildup of plaque that can
narrow the common or internal artery.
Severe blockage is called
carotid artery stenosis. Carotid artery stenosis or disease is a major risk
factor the ischemic stroke, which is the most common form of stroke and is
usually caused by a blood clot plugging an artery. Plaque formation occurs
when cholesterol, fat and other substances build up in the inner lining of
an artery. Some patients may or may not experience symptoms, however some of
the symptoms to be aware of are:
* difficulty speaking
* loss or blurred vision in one eye
* loss of strength in an arm or leg
* numbness in an arm or leg
If you experience any of these symptoms even if they resolve themselves,
please call 911 or call your physician immediately. During a physical exam,
your doctor may hear an abnormal sound, called a bruit when he or she
listens to your carotid arteries with a stethoscope.
There is treatment available for carotid stenosis and Dr. Khash Salartash
has many years of experience performing minimally invasive surgery to treat
this disease. The first step to diagnosing the extent of the disease is to
undergo non-invasive testing. The most common test is called a duplex
ultrasound. The ultrasound can also determine the location and degree of
narrowing in your carotid arteries. There are other tests that are used to
determine the extent of stenosis and Dr. Salartash will decide which one is
best for you.
Some of these other tests include - CT scan, MRA, and Angiography.
The most commonly performed vascular surgery to treat carotid stenosis is
called carotid endarterectomy. Carotid
endarterectomy may help prevent your risk of having a stroke. During this
surgery, Dr. Salartash will remove plaque buildup in the carotid artery by
dissecting out the plaque with fine instruments and meticulous care. During this 2
hour surgical procedure, neuromonitoring will be available to monitor brain
function during your surgery. Blood flow to your brain will be provided by
a temporary shunt and also
the opposite carotid artery.
Dr. Salartash will use a patch to widen the artery. This patch can be
your own vein or a synthetic material. Dr. Salartash will determine which
is the best option for you based on your particular needs. You will remain
hospitalized for 1-3 days and you will need to avoid strenuous activity for
several weeks.
You will need to have duplex ultrasounds at least twice yearly following
carotid endarterectomy.
There are many risk factors for carotid stenosis and stroke. Some of these
are:
* hypertension
* cigarette smoking
* alcohol abuse
* family history
* poor diet
* high cholesterol
Prior to surgery, your surgeon will give you a
thorough examination, including obtaining a complete medical and family
history. You will also need to give your surgeon a list of all of your
medications, and provide information regarding a prior surgeries.
a localized area of atheroma The artery is closed using
is seen
above a
patch
Our facility has a fully equipped vascular lab where each day our certified
and experienced vascular technicians use doppler color flow ultrasound
technology to perform various ultrasound procedures. To check for carotid
stenosis, you will undergo a painless, non-invasive 20 minute procedure.
The technician will apply ultrasound gel to the area of the neck and using a
transducer (a special instrument) the technician will move the wand back and
forth over the carotid arteries. The transducer will create images on a
screen which will aide the technician in assessing the rate of blood flow
within the arteries; thereby determining whether or not there is evidence of
plaque build-up.
Your technician will document your individual results as one of the
following:
* within normal limit
* mild to moderate risk
* moderate risk
* extensive plaque build-up
