Carotid Artery Disease
Carotid Artery Disease is a condition in which the carotid arteries become narrowed or blocked. When the arteries become narrowed, blood can’t reach the brain. This is one of the causes of stroke and the condition is called carotid stenosis.
Risk factors for blockage of the arteries include:
- Alcohol abuse
- Cocaine use
- Family history of stroke
- High blood pressure
- High cholesterol
- Increasing age
Test to diagnose carotid artery disease:
Carotid Ultrasound (Standard or Doppler):
This noninvasive, painless screening test uses high-frequency sound waves to view the carotid arteries. It looks for plaques and blood clots and determines whether the arteries are narrowed or blocked. A Doppler ultrasound shows the movement of blood through the blood vessels. Ultrasound imaging does not use X-rays.
Magnetic Resonance Angiography (MRA):
This imaging technique uses a powerful magnet to gather accurate information about the brain and arteries. Then a computer uses this information to generate high-resolution images. An MRA can often detect even small strokes in the brain.
Computerized Tomography Angiography (CTA):
More detailed than an X-ray, a CT uses X-rays and computer technology to produce cross-sectional images of the carotid arteries. Images of the brain can be collected as well. With this imaging test, the scan may reveal areas of damage on the brain. The CT scan uses a low level of radiation.
Cerebral Angiography (Carotid Angiogram):
This procedure is considered the gold standard for imaging the carotid arteries. It is an invasive procedure that lets a doctor see blood flow through the carotid arteries in real time. Cerebral angiography allows the doctor to see narrowing or blockages on a live X-ray screen as contrast dye is injected in the carotid arteries. This procedure provides the best information. It does carry a small risk of serious complications.
Angioplasty & Stenting:
Carotid artery stenting is an effective alternative to carotid artery endarterectomy as demonstrated in randomized controlled clinical trials (SAPPHIRE and CREST Trials). In carotid artery stenting, an embolic protection device is placed across the carotid artery stenosis. The embolic protection device reduces embolization of debris during the carotid artery stent deployment. The carotid artery stent is placed via the embolization device which serves as a tracking mechanism for the carotid artery stent placement. Once the stent is deployed, the embolization device is removed leaving the deployed stent to improve carotid flow, stabilize and trap plaque.
Carotid artery Endarterectomy:
Carotid artery endarterectomy is the surgical procedure in which a vascular surgeon surgically opens the carotid artery and removes the plaque from the artery to reduce the risk of future strokes.