Carotid artery disease, also known as carotid occlusive disease or carotid stenosis, occurs when the major arteries in the neck become narrowed or blocked due to fatty build-up or plaques. Risk factors for carotid artery disease include:
- Cigarette smoking
- Aging: risk for the condition increases as you age
- High blood pressure
- High cholesterol
- A family history of atherosclerosis or stroke
Carotid Artery Disease Care at UVM Medical Center
The University of Vermont Medical Center's vascular technologists are specially trained in the latest techniques to diagnose carotid artery disease. Diagnostic tests are performed in our non-invasive diagnostic laboratory located within the Vascular Surgery offices. Our trained vascular surgeons offer expert care in a personalized manner, working closely with you and your family. We offer the latest surgical and minimally invasive treatments for carotid artery disease, as well as medical management and help with lifestyle modifications.
Carotid Artery Disease Diagnosis
Carotid Artery Disease in the early stages may not produce any symptoms. The first signal you have the disease may be a mini-stroke known as a transient ischemic attack or TIA. The warning signs for TIA include:
- Sudden numbness, weakness or paralysis on one side of the body
- Slurred speech
- Losing vision in one eye
If you experience any of these warning signs, even if only for a few minutes, you should seek medical attention immediately. If the symptoms last only for a short while, it is still important to talk to your doctor. A TIA is a warning sign that you are at risk of a full-blown stroke, which is permanent damage to your brain.
The process of diagnosis may involve the following:
- Physical exam - Your physician will conduct a full medical history and physical exam. He or she will listen for sounds of turbulent blood flow in your carotid arteries.
- Carotid duplex ultrasound - With this test, a vascular technician holds a small ultrasound probe to your neck. High-frequency sound waves emitted by the probe bounce off the blood cells and vessels. The sound waves create an image of blood flow and blood vessel structures.
Non-invasive vascular laboratory
Diagnosing vascular problems typically begins in the Vascular Surgery clinic at The UVM Medical Center's Ambulatory Care Center. Patients are often able to see a doctor and have a non-invasive test during a single visit.
The lab is staffed by registered vascular technologists -- specialists with advanced training in non-invasive vascular imaging and testing. By focusing solely on vascular problems, these technologists bring an in-depth knowledge to the diagnosis of vascular patients.
The lab offers imaging and testing for the full range of vascular problems affecting all areas of the body. It provides two main types of testing - physiological studies and ultrasound imaging. Both are non-invasive tests that are usually painless and relatively quick. They enable your physician to decide whether additional, more invasive tests are needed. These studies also can identify problems such as arterial atherosclerosis or vein disease.
- Physiological studies - Studies that measure the amount of blood traveling through the vessels with and without exercise. They help determine if blockages exist.
- Ultrasound imaging - An imaging study that uses sound waves to produce a video image of your blood vessels. Ultrasounds are used to check for a potential aneurysm, as well as blocked blood vessels in the neck, abdomen or extremities. In some cases, it may be the only test necessary to determine the need for an operation or stenting procedure.
Treatments for Carotid Artery Disease
The goal in treating carotid artery disease is to prevent stroke. The type of treatment that is right for you will depend on the severity of your condition, your general health, and the presence or lack of symptoms.
Carotid Artery Non-Surgical Treatments
- Lifestyle Changes - Atherosclerosis, an underlying cause of carotid artery disease, often results from unhealthy habits and lifestyles. At The UVM Medical Center, we are dedicated to patient education and helping you change your habits and adopt a healthy lifestyle.
- Improving diet and exercise - Changes such as smoking cessation, exercise, and weight loss can help reduce stress on your arteries and slow the process of atherosclerosis. We will help connect you with the resources you need to modify your lifestyle.
Medication may be recommended to help control carotid artery disease, and the underlying causes of the disease. We offer the full range of medical therapies and the latest pharmaceutical products available to treat your problem. Your physician may prescribe blood-thinning medication or medicines to control your blood pressure or lower cholesterol. Other medications may be prescribed for patients with chronic conditions such as diabetes to help keep those conditions under control.
If your carotid artery disease is severe, or if you've already experienced a TIA or stroke, surgery may be necessary. Our vascular surgeons perform the latest surgical techniques to treat carotid artery disease. There are two main types of procedures for carotid artery disease. These include:
- Carotid endarterectomy - This is the most common surgical procedure for carotid artery disease, with low risk for otherwise healthy patients. Your surgeon will make an incision in the neck, open the affected artery and remove the plaque. The artery is then closed with sutures. Once the plaque is removed, the artery is once again smooth and open. The procedure usually requires a one night hospital stay.
- Carotid angioplasty and stenting - This is a newly developed minimally invasive procedure for treating carotid artery disease. It may be recommended for patients experiencing symptoms who are considered at high risk for surgical endarterectomy. Your surgeon and care team will help determine whether this procedure is right for you. Stenting typically is only indicated if you are experiencing symptoms. With this procedure, a catheter with a special balloon on the end is guided into an artery in the groin. The catheter is guided to the blocked area in the neck. Once in place, the balloon is inflated and deflated several times to widen the damaged artery. Once the artery is opened, the surgeon places a stent -- a tiny wire mesh tube -- in the artery to keep it open and allow blood to flow more freely. Similar to endarterectomy, angioplasty, and stenting usually require an overnight hospital stay.