Carotid Stenosis
Finding and treating narrowing in the neck arteries that supply your brain, with endarterectomy when it is warranted.
The carotid arteries run up either side of your neck and carry most of the blood going to your brain. Carotid stenosis is narrowing of one of them, usually from plaque building up along the wall. It often causes nothing you can feel. The risk is that a piece of that plaque breaks loose and travels to the brain, which is one of the ways a stroke happens.
A carotid duplex ultrasound in our office measures how narrow the artery is and how fast blood is moving through it. It takes about twenty minutes, involves no needles or dye, and Dr. Caruso reviews the images with you the same visit. CT or MR angiography is added when we are planning surgery. Sudden weakness on one side, trouble speaking, or loss of vision in one eye is an emergency, so call 911 rather than waiting for an appointment.
Moderate narrowing that has caused no symptoms is often managed medically, with cholesterol and blood pressure control, antiplatelet medication, and follow up ultrasound to watch for change. When the narrowing is severe, or when it has already caused a stroke or a TIA, carotid endarterectomy removes the plaque from inside the artery through a small incision in the neck. Stenting is the alternative for patients whose anatomy or overall health makes open surgery riskier.
FAQ
Frequently asked questions
The things patients ask us most about carotid stenosis, answered plainly.
You may not. Whether treatment lowers your risk more than careful monitoring depends on how narrow the artery is, your age, and your other health conditions. Dr. Caruso goes through where you sit before anything is scheduled.
Stroke symptoms that clear up on their own within minutes or hours. Nothing is left behind, but it is a warning sign and it should be evaluated right away rather than shrugged off.
An overnight stay in the hospital is typical, with a small incision placed in a crease of the neck to care for. Most people are back to normal activity within a couple of weeks.
Endarterectomy has the longer track record for most patients. Stenting avoids an incision and general anesthesia, which matters for some. Your imaging and your overall health decide which one is the safer choice for you.
That sound is called a bruit, and it is turbulent blood flow moving past a narrowed spot. It is a common reason people are referred for a carotid ultrasound, and the ultrasound is what tells us whether narrowing is actually there.
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