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Carotid Artery Disease

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  • Unable to speak or understand speech
  • Paralyzed on one half of their body
  • Unable to dress, feed, or take care of themselves
  • TIAs " � TIA stands for "transient ischemic attack. " � TIAs are basically strokes that last only a short time. But they do not cause brain damage. TIAs happen when a blood vessel in the brain gets clogged briefly and then reopens. People who have TIAs can have the symptoms of a stroke, but the symptoms go away in a short time. People who have TIAs are at very high risk of having a full-blown stroke.

  • Is there a test for carotid artery disease? " � Yes. Doctors can listen to each carotid artery with a stethoscope. They do this to check for a swishing sound that occurs when the artery is partly blocked. But to be sure, doctors also can use one of the following tests, which create pictures of the arteries: � �
    • Carotid duplex ultrasound " � This test uses sound waves to create pictures.
    • Magnetic resonance angiography (MRA) " � This test uses a magnet to create pictures. It works the same way that MRI tests work. Before having MRA, most people get an injection of a chemical that makes the arteries show up more clearly.
    • Computed tomography angiography (CTA) " � This test uses a special kind of X-ray called a CT scan. Before having the scan, people get an injection of a chemical that makes the arteries show up more clearly.

    There is another test that doctors sometimes use, called a "cerebral angiogram. " � But that is not usually necessary. � �
    How is carotid artery disease treated? " � Treatments for carotid artery disease focus mostly on preventing stroke. Treatments can include: � �
    • Lifestyle changes " � People can reduce their risk of stroke by:
      • Quitting smoking if they smoke
      • Being active
      • Losing weight if they are overweight
      • Eating a diet low in fat and cholesterol and high in fruits, vegetables, and low-fat dairy foods
    • Medicines " � Different people need different medicines to reduce their chances of having a stroke. In general, the medicines that can help prevent strokes include:
      • Medicines to lower blood pressure
      • Medicines called statins, which lower cholesterol
      • Medicines to prevent blood clots, such as aspirin
    • Surgery " � Doctors can do surgery to remove plaque from the carotid arteries (figure 2). This is called "carotid endarterectomy. " � This treatment is most appropriate for people who have had a TIA or stroke and who have a lot of plaque in their carotid arteries. It is also appropriate for some people who have not had a stroke or TIA but who have a lot of plaque in their carotid arteries.
    • Carotid stenting " � Carotid stenting is when doctors insert a tiny metal tube called a "stent " � into the carotid artery. The stent is designed to prop open narrowed arteries. This treatment seems to be more dangerous than surgery, especially for people age 70 or older. It is not appropriate for most people.

    Which treatment is right for me? " � The right treatment for you will depend on: � �
    • Whether you have already had a stroke or TIA that seemed to be caused by your carotid artery disease
    • How much of your carotid artery is blocked off by plaque
    • How old you are
    • Whether you are a man or a woman
    • Whether you have other health problems besides carotid artery disease

    If your doctor suggests surgery or stenting, ask these questions: � �
    • What are the chances that I will have a stroke in the next 5 years if I do not have this procedure?
    • What are the chances that I will have a stroke in the next 5 years if I do have this procedure?
    • What are the risks of the procedure?
    • Does the surgeon who will do the procedure have a lot of experience?

    All topics are updated as new evidence becomes available and our peer review process is complete. � �
    This topic retrieved from UpToDate on: Nov 04, 2014. � �
    Topic 15819 Version 3.0 � �
    Release: 22.8 - C22.208 � �
    � � 2014 UpToDate, Inc. All rights reserved. � �


    figure 1

    Carotid artery disease

    In people with carotid artery disease, fatty deposits called plaques build up inside the artery walls. These plaques can break open and cause blood clots to form, and that can lead to stroke.

    Graphic 72617 Version 2.0

    View Originalfigure 1

    Carotid artery disease

    In people with carotid artery disease, fatty deposits called plaques build up inside the artery walls. These plaques can break open and cause blood clots to form, and that can lead to stroke.

    Graphic 72617 Version 2.0

    View Original
    figure 2

    Carotid artery surgery (endarterectomy)

    During carotid artery surgery, also called "endarterectomy," the doctor clamps the carotid artery above and below the area that has plaque. Then the doctor cuts open the artery and removes the plaque. Next, he or she sews the artery back together and unclamps the artery.

    Graphic 52730 Version 4.0

    View Originalfigure 2

    Carotid artery surgery (endarterectomy)

    During carotid artery surgery, also called "endarterectomy," the doctor clamps the carotid artery above and below the area that has plaque. Then the doctor cuts open the artery and removes the plaque. Next, he or she sews the artery back together and unclamps the artery.

    Graphic 52730 Version 4.0

    View Original

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    This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.The use of UpToDate content is governed by the UpToDate Terms of Use. � �2014 UpToDate, Inc. All rights reserved. � �

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