Carotid Vascular Disease Treatment & Care at University Hospitals

At University Hospitals Harrington Heart & Vascular Institute, we bring together renowned vascular specialists and leading-edge technologies to give patients the very best care for carotid artery disease, the cause of about one-fifth of preventable strokes.

Carotid arteries are the primary blood vessels that carry blood and oxygen to your brain. You can actually feel your pulse on both sides of the neck under your jaw. When these arteries become narrowed, it’s called carotid artery disease. The narrowing of the arteries is caused by a buildup of fatty substances, calcium and other waste products called plaque, inside the artery lining.

Carotid artery disease reduces the flow of blood and oxygen to the brain. If the narrowing of the carotid arteries becomes severe enough that blood flow is blocked—or, if a piece of plaque breaks off and blocks the artery—it can cause a stroke, which deprives your brain of oxygen. Within minutes, brain cells begin to die. Stroke can cause lasting brain damage, long-term disability, such as vision or speech problems and paralysis, or death.

Recognizing Mini-Stroke and Other Risk Factors for Carotid Artery Disease

Carotid artery disease develops slowly and often without symptoms. For many people, the condition goes unnoticed until it severely narrows or blocks a carotid artery, causing a “mini-stroke” or transient ischemic attack, also called TIA. During a mini-stroke, you may have some or all symptoms of a stroke. However, these symptoms usually go away on their own within 24 hours. Anyone who has had one or more mini-strokes, or TIAs, is almost 10 times more likely to have a stroke than someone of the same age who hasn't had these less noticeable events.

Recognizing and treating TIAs can reduce your risk of a major stroke. Stroke and mini-stroke symptoms may include:

• A sudden, severe headache with no known cause
• Dizziness or loss of balance
• Inability to move one or more of your limbs
• Sudden trouble seeing in one or both eyes
• Sudden weakness or numbness in the face or limbs, often on one side of the body
• Trouble speaking or understanding speech

Other factors that increase your risk of carotid artery disease include:

• Age
• Diabetes
• Diet high in fat
• Family history
• High blood pressure
• High cholesterol
• Lack of exercise
• Obesity
• Sleep apnea
• Smoking

While these factors may increase your risk, they do not always cause the disease. However, knowing they exist can give you the motivation to work hard on making lifestyle changes to reduce your chances of carotid artery disease or stroke.

Pinpointing Carotid Artery Disease with the Latest Diagnostic Technologies

To determine if you have carotid artery disease, your vascular specialist at University Hospitals will review your complete medical history, conduct a physical exam and review all imaging test results.

Because many times carotid artery disease symptoms may not appear, your doctor may place a stethoscope over your carotid arteries to listen for any abnormal sounds that may indicate reduced blood flow.

To find out more, your doctor will ask whether you’ve had any symptoms of a mini-stroke or stroke. The following additional tests may be recommended:

• Angiography: This test is used to assess how blocked the carotid arteries are by taking X-ray images while a contrast dye is injected.
• Carotid artery duplex scan: This test is done to assess the blood flow of the carotid arteries using ultrasonic sound waves.
• Computed tomography angiography (CTA): Using X-rays and computer technology with contrast dye, a CTA shows images (often called slices) of the body. A CTA shows detail of blood vessels and can help identify narrowed blood vessels.
• Magnetic resonance angiography (MRA): Using magnetic resonance imaging (MRI) technology and intravenous (IV) contrast dye, and MRA makes blood vessels visible.
• Magnetic resonance imaging (MRI) scan: This procedure uses a combination of large magnets, radiofrequency energy and a computer to make detailed images of organs and structures in the body.

Leading Experts in Treating Carotid Artery Disease

Our primary goal for carotid artery disease treatment is to reduce your risk of stroke and halt the progression of your level of carotid artery disease. With some of the country’s leading heart and vascular experts at University Hospitals, our patients with carotid artery disease see an entire multidisciplinary team. Our carotid artery specialists work in collaboration with stroke experts at UH Neurological Institute for comprehensive care.

In many cases, lifestyle changes, exercise and medications are enough for patients to see positive outcomes. Our highly trained specialists are leaders in carotid artery surgery. Surgery is often recommended if the arteries are more than 70 percent narrowed or if you’ve had symptoms of a mini-stroke. Surgical treatment of carotid artery disease includes:

• Carotid endarterectomy (CEA): This surgery removes plaque and blood clots from the carotid arteries.
• Carotid artery stenting (CAS): This is an option for those who are unable to have carotid endarterectomy. This minimally invasive procedure opens the blocked artery with a balloon and then keeps it open with a wire-mesh stent.
• Transcarotid stenting: Vascular specialists at UH are also participating in the trial of an investigational device used during trans-carotid stenting. Whereas the CAS procedure threads the catheter to the blocked artery through an incision in the groin, this new approach makes a small incision in the neck, making it a much more direct approach.

Find Expert Treatment for Carotid Artery Disease

If you or a loved one has experienced any carotid artery blockage symptoms, reach out to one of our specialists. Our team can provide the accurate diagnosis and innovative treatment you may need – at a range of convenient locations.