What are my treatment options for Carotid Artery Disease?
Treatment depends upon the stage of the disease itself and whether you are experiencing symptoms from the disease. Medications and lifestyle modifications are the first step in early disease, with minimally invasive and surgical intervention being considered once the disease has become severe.
Lifestyle modifications would include quitting smoking, trying to maintain a healthier weight and getting regular exercise. Also, it is very important to control other risk factors, by taking the appropriate prescribed medications to control blood pressure, cholesterol, and diabetes. Aspirin may be added to thin your blood and statins to help prevent further plaque buildup in your arteries from high cholesterol.
Other interventions are considered once carotid artery disease has progressed to a severe stage. This would mean you are having TIA symptoms, you have had a stroke in the past, or one of the carotid arteries is severely narrowed, with or without symptoms. These interventions include the following:
- Carotid angioplasty and stenting: this is a minimally invasive procedure that involves inserting a long, thin flexible tube called a catheter through a small puncture over an artery in your groin. Under x-ray guidance, this catheter is directed through the blood vessels to the affected carotid artery. The surgeon will inject contrast dye through the catheter while taking an x-ray picture to determine the extent and location of the blockage. A special balloon at the end of the catheter is inflated and deflated several times in order to compress the plaque against the walls of the artery. This widens the opening of the blood vessel, so blood is able to flow freely through it. The surgeon will then place a mesh-like metal tube called a stent within the artery to keep it open. This is generally performed using local anesthetic and requires a short hospital stay of 1 day.
- Carotid Endarterectomy: An incision is made on the affected side of the neck and the plaque is removed from the inner lining of the carotid artery. Depending on the extent of disease to the artery, a patch of material may be sewn in place to make up for the lack of healthy artery when it is sewn back together. The blood flow is fully restored to the brain following the procedure. This requires a hospital stay of about 1 day.