How To Treat And Prevent Carotid Stenosis

Carotid stenosis happens when the carotid arteries narrow over time. Much like other types of artery disease, carotid stenosis is caused by plaque or cholesterol deposits and fatty substance build up in the carotid arteries. These arteries are what give the front of the brain its oxygenated supply of blood. There are two carotid arteries, and they are the lifeline to the part of the brain that controls speech, sensory functions, thinking functions, personality, and motor functions. When carotid stenosis occurs, there is decreased blood flow to the brain, which can cause a stroke. A stroke happens when the brain is cut off from blood flow due to a broken off piece of plaque, a blood clot that gets stuck, or when an artery narrows to the point of being fully blocked. Strokes can cause permanent brain damage or death, and individuals with carotid stenosis are at a much higher risk of experiencing one.

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Carotid Endarterectomy

Carotid endarterectomy procedures are recommended for patients who have a moderate to severe case of carotid stenosis with a blockage of between fifty and one hundred percent. When this procedure is carried out, the patient is given local or general anesthesia and the surgeon makes an incision on the neck to access the affected carotid artery. The surgeon makes another incision to the artery itself to extract the plaque inside of it causing the narrowing or clogging. Once they extract as much plaque as they can, they stitch up the carotid artery, sometimes using a patch graft to do so. An endarterectomy can also be done with a technique called carotid eversion endarterectomy, in which the surgeon cuts the artery and removes the plaque after the artery has been turned inside out. Once the plaque has been extracted, the surgeon will then reattach the artery to itself. While this procedure is relatively successful, the plaque can still build up and accumulate on the artery walls again over time.

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Carotid Angioplasty And Stenting

Carotid angioplasty and stenting is done when there is a carotid artery blockage of seventy percent or greater. This procedure is ideal for individuals who have had a stroke before and are not stable enough to have surgery performed in the neck. Sometimes the angioplasty and stenting are done when another blockage develops after a carotid endarterectomy. Sometimes this approach is used in cases where the carotid blockage is in a location that is too difficult to perform an endarterectomy on. In this procedure, a catheter with a small balloon attached is inserted into the affected carotid artery and inflated. This allows the artery to be widened and for blood to freely flow into the brain. Then a stent is placed in the artery to hold it in place so the artery does not narrow again. A stent is a metal coil that fits comfortably into the artery. While this procedure is also successful in the short term, the plaque can begin to build up after the procedure again in the carotid artery. Usually, patients are put on blood thinners after the stent placing to prevent blood clots.

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