Carotid Artery Disease

Carotid artery disease may have no symptoms, and sometimes, the first sign of the disease is a transient ischemic attack (TIA) or stroke. TIA is a sudden, temporary loss of blood flow to an area of the brain. Usually lasting a few minutes to an hour, these symptoms are signs of a medical emergency. Call 911 right away if you experience any of the following:

• Sudden weakness or clumsiness of an arm or leg on one side of the body
• Sudden paralysis of an arm or leg on one side of the body
• Loss of coordination or movement
• Confusion
• Decreased ability to concentrate
• Dizziness
• Fainting
• Headache
• Numbness or loss of feeling in the face or in an arm or leg
• Temporary loss of vision or blurred vision
• Inability to speak clearly or slurred speech

At INTEGRIS we use the most advanced imaging methods and diagnostic tools to determine the cause, severity and prognosis of your heart condition. Some of these diagnostic tests may include:

• Physical Exam: Your doctor places a stethoscope over the carotid artery to listen for a sound made when blood passes through a narrowed artery. This can be a sign of atherosclerosis. But, an artery may be diseased without producing this sound.
• Carotid Artery Duplex Scan: This test is done to assess the blood flow of the carotid arteries. A probe called a transducer sends ultrasonic sound waves through the skin and other body tissues to the blood vessels, where the waves echo off the blood cells. Absence of or faintness of these sounds may mean blood flow is blocked.
• Cardiac MRI (magnetic resonance imaging) Scan: A combination of large magnets, radiofrequency energy and a computer makes detailed images of organs and structures in the body. For this test, you lie inside a big tube while magnets pass around your body.
• Magnetic Resonance Angiography (MRA): Uses MRI and intravenous contrast dye to make the blood vessels visible. Contrast dye causes blood vessels to appear solid on the MRI image so the doctor can see them.
• Computed Tomography Angiography (CTA): Uses X-rays and computer technology along with contrast dye to make horizontal, or axial, images (often called slices) of the body. A CTA shows pictures of blood vessels and tissues and is helpful in identifying narrowed blood vessels.
• Angiography: This test assesses carotid artery blockage by taking X-ray images as contrast dye is injected. Contrast dye helps the doctor see the shape and flow of blood through the arteries as X-ray images are made.

Your multidisciplinary team will craft a specific treatment plan for your carotid artery disease based on your age, overall health, medical history, the extent of the disease and your tolerance for specific medications, procedures or therapies. Of course, your personal opinions and preferences will also be taken into consideration. Treatments may include:

Lifestyle Changes

• Quit Smoking: Quitting smoking can reduce the risk for carotid artery disease and cardiovascular disease. All nicotine products, including electronic cigarettes, constrict the blood vessels. This decreases blood flow through the arteries.
• Reduce Cholesterol: Eating a low-fat, low-cholesterol diet can help fight carotid artery disease. Eat plenty of vegetables, lean meats (avoid red meats), fruits and high-fiber grains. Avoid processed foods, and foods high in saturated and trans-fats. When diet and exercise are not enough to control cholesterol, you may need medicines.
• Reduce Blood Sugar: High blood sugar (glucose) can cause damage and inflammation to the lining of the carotid arteries. Control glucose levels through a low-sugar diet and regular exercise. If you have diabetes, you may need medicine or other treatment.
• Exercise: Exercise can help you maintain a healthy weight and reduce risks for carotid artery disease. Lack of exercise can cause weight gain and raise blood pressure and cholesterol.
• Reduce Blood Pressure: High blood pressure causes wear and tear and inflammation in blood vessels, increasing the risk for artery narrowing. Blood pressure should be below 140/90 for most people. People with diabetes may need even lower blood pressure.

Medicines

• Antiplatelets: These medicines deter the ability of platelets in the blood to stick together and cause clots. Aspirin, clopidogrel and dipyridamole are examples of antiplatelet medicines.
• Cholesterol-Lowering Medicines: Statins are cholesterol-lowering medicines including simvastatin and atorvastatin. Studies show certain statins can decrease the thickness of the carotid artery wall and increase the size of the opening of the artery.
• Blood Pressure-Lowering Medicines: Several different medicines work to lower blood pressure.

Surgery

• Carotid Endarterectomy (CEA):This surgery removes plaque and blood clots from the carotid arteries. CEA may help prevent a stroke in people who have symptoms and a narrowing of 70% or more.
• Carotid Artery Angioplasty With Stenting (CAS): This option is for people unable to have CEA. Using a very small hollow tube, or catheter, threaded through a blood vessel in the groin to the carotid arteries, a balloon is inflated to open the artery and a stent is placed. A stent is a thin, metal-mesh framework used to hold the artery open.

Part of heart and vascular care includes managing heart disease and preventing further deterioration to help you live the fullest life possible. To accomplish that, we’ll provide you with education, continued care options and programs even after you are discharged. These include:

• Cardiac Rehabilitation
• Heart Education
• Anticoagulation Management Clinic
• Heart Care Program
• Integrative Medicine
• Palliative Care