I was told I have Carotid Artery Disease... What are my options?

Have you been told you have diseased or clogged carotid arteries (carotid stenosis)? Are you nervous about what this may mean in terms of your risk of stroke? Here are some answers to commonly-asked questions regarding Carotid Artery Disease.

What are the carotid arteries?

Carotid arteries are the two main blood vessels that supply most of your brain with blood.

What is a carotid bruit and does it definitely mean that the carotid is blocked?

A carotid bruit is a physical exam finding in which the physician hears a swooshing sound in the neck. When blood passes through a narrowing channel, it will give a very distinctive sound when your doctor listens with a stethoscope. Approximately 30% of patients with a carotid bruit will have a significant carotid blockage. However, carotid bruits are often associated with the presence of other atherosclerotic heart disease as well as other cardiovascular problems.

How is a carotid bruit assessed by my physician?

Most of the time, a simple carotid ultrasound will determine the presence and degree of carotid blockage. There are usually all types of ultrasound labs that are more skilled than others; therefore, make sure the lab you visit is "ICAVL Accredited" for an accurate assessment. If more information is needed after your ultrasound, a CT scan or MRI with contrast is performed.
What are the risks associated with carotid artery blockage?

The biggest concern is the risk of stroke. Stroke is the leading cause of serious, long-term disability in the
United States. Each year, about 795,000 people suffer a stroke. About 600,000 of these are first attacks, and 185,000 are recurrent attacks. Approximately 30% of strokes are related to carotid disease.

What is the treatment of carotid disease?

The greater the degree a carotid artery is blocked, the greater the risk of stroke. While surgery/stenting is offered for patients with severe blockage, most patients with carotid disease do well with aggressive medical management in order to prevent progression of the blockage. This medical management includes lowering your cholesterol, stopping smoking, decreasing your blood pressure, eating healthier, taking an aspirin, and controlling your blood sugar if you are diabetic.

What if a stroke already happened and they have found carotid disease?

In this setting, it is even more important to have your carotid disease checked. If a patient already had a
stroke or a mini-stroke (TIA) from carotid disease, this is called Symptomatic Carotid Disease. Patients with symptomatic disease are at very high risk of having a major stroke. While optimal medical management is important for every circumstance, there is a lower threshold for surgery for the "symptomatic patient".

What should I do if I am found to have carotid disease?

The most important thing to do is to see a vascular surgeon who specializes in both surgical carotid endarterectomy as well as minimally-invasive stenting. This will allow the best possible treatment to be selected for your particular disease.

About Cooper Vascular Surgery:

The Division of Vascular and Endovascular Surgery at Cooper University Health Care is a comprehensive vascular care program designed to minimize complications from arterial and venous diseases and to treat problems with a minimally invasive method called endovascular surgery.

We provide comprehensive treatment for blood vessel disorders, such as arterial disease, phlebitis, varicose veins, carotid artery disease and problems of the aorta, iliac, femoral, renal and other arteries, aneurysms, arterial occlusions and limb salvage surgery. Our division consists of nationally and internationally renowned vascular surgeons who have extensive traditional open surgical skills as well as cutting-edge endovascular techniques. At Cooper, you'll have access to the latest that vascular technology has to offer, including endovascular stent grafts, aortic dissection stents, cutting balloons, cerebral protection devices for carotid stenting and more.

Our team of vascular surgeons is among the best in the region - and the nation - and they have been ranked as top doctors by U.S. News & World Report, Best Doctors in America, Castle Connelly, Philadelphia magazine and South Jersey Magazine.
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