Carotid Artery Interventions

Often suffering a TIA is the first indication that you have carotid artery problems.Carotid arteries are the blood vessels that supply blood to the brain. Buildup of plaque in the carotid arteries can result in transient ischemic attack (TIA), a temporary loss of function of brain that comes back quickly, or stroke, a more permanent loss of function.

Disease occurs when fatty deposits called plaques clog these blood vessels, a condition called atherosclerosis. Stroke deprives your brain of oxygen. Within minutes, brain cells begin to die. Stroke is the most common cause of death and the leading cause of permanent disability in the United States. Carotid artery disease develops slowly. Often suffering a TIA is the first indication that you have carotid artery problems.

Cholesterol, calcium fibrous tissue and other cellular debris comprise plaque, which usually forms at microscopic injury sites within your arteries. Narrowed carotid arteries have difficulty delivering the oxygen and vital nutrients your brain needs for daily functioning.

SYMPTOMS

In the early stages, the disease often doesn’t produce any signs and it may progress unnoticed until it’s serious enough to deprive your brain of blood, causing a stroke or TIA.

Signs and symptoms of a stroke or TIA include:

• Sudden numbness or weakness in the face or limbs, often on only one side of the body
• Sudden trouble speaking and understanding
• Sudden trouble seeing in one or both eyes
• Sudden dizziness or loss of balance
• Sudden severe headache with no known cause

See a doctor immediately if you have one or more of these symptoms, even if they disappear as suddenly as they appeared as you may have experienced a TIA. Medical treatment is necessary to avoid a full-blown stroke. Carotid artery disease causes about 10% to 20% of strokes.

RISK FACTORS

Factors that increase your risk include:

• High blood pressure, which weakens artery walls and makes them more vulnerable to damage
• The nicotine in cigarettes irritates the inner lining of your arteries while smoking itself increase heart rate and blood pressure
• Diabetes lowers your ability to process fats efficiently, placing you at greater risk of high blood pressure and atherosclerosis
• High blood-fat levels, particularly low-density lipoprotein (LDL) cholesterol and triglycerides encourage accumulation of plaques
• Family history
• Age
• Obesity
• Sleep apnea, as spells of stopped breathing at night can increase your risk of stroke
• Lack of exercise contributes to conditions that damage your arteries

TREATMENT

Diagnosis and treatment of carotid artery disease is very important to prevent TIA/stroke. Dr. Sidhu will discuss carotid artery disease and if needed will do ultrasound in the office to diagnose the degree of blockage. Treatment of carotid artery disease usually involves a combination of lifestyle changes, medication and surgery, when necessary.

Mild to Moderate Blockage

Lifestyle changes can be effective in slowing the progression of atherosclerosis. If you fit this category, VIVAA will help you modify your lifestyle through various means that can include:

• Eliminating use of tobacco
• Eating a healthy diet with foods low in saturated fats, cholesterol and sodium
• Maintain a desirable weight
• Exercise regularly, at least 30 minutes several times per week
• Limit alcohol consumption
• Medications to control blood pressure and diabetes and lower cholesterol
• Anti-platelet medication to reduce the risk of stroke and other cardiovascular disease complications

Severe Blockage

Depending on the severity of blockage, we will explain all treatment options in detail. If intervention is needed, we will recommend placing a stent across the blocking or performing an open surgical procedure called carotid endarterectomy to fix that the carotid artery blockage.

We will discuss both procedures in detail and develop an individualized plan. It is very important to diagnose and treat carotid artery disease in a timely fashion to prevent a potentially life-threatening event like stroke. These procedures are performed if you have at least a 50-75% blockage with previous symptoms, or an 80% blockage without symptoms.

Carotid Endarterectomy

This is the most common treatment for severe carotid artery disease.It can be performed under general anesthesia or local anesthesia with intravenous sedation. After making an incision along the front of your neck, Dr. Sidhu will open the affected carotid artery and remove the plaques, restoring blood flow to the brain through its normal path. The artery is repaired with either stitches or a graft.

After treatment, you will have a sore throat and the skin on your neck will be sore. Risks include stroke or TIA in a small percentage of patients who have not had previous symptoms, along with heart attack or nerve damage that can affect your larynx, tongue or back.

Carotid Angioplasty and Stenting

If the blockage is too difficult to reach with carotid endarterectomy, or if you have other health conditions that make surgery too risky, you’ll undergo this procedure. You’ll receive local anesthesia and a tiny balloon will be inserted via a catheter to the area of the clog where it is then inflated to widen the artery. A small wire mesh coil called a stent is inserted to keep the artery from narrowing again.

Patients usually stay in the hospital one to two days following the procedure. Risks include infection, heavy bleeding, artery injury, allergic reaction, stroke and heart attack. Your risks may vary based on your overall health, the severity of your condition and whether you have other complications such as diabetes or hypertension.

Patient Review

"Dr. Sidhu and his staff were very supportive as he diagnosed and surgically repaired my carotid artery. I felt his warmth and personal concern that comforted me throughout the process."
R.O.

When you need vascular and endovascular procedures or vascular ultrasound, choose the double board-certified surgeon at Vein Vascular, Primary care & Aesthetic Services. For more information or to make an appointment, call us today at 425-250-9999. For your convenience, you can use our online Request an Appointment form.