What
Are the Carotid Arteries?
The
carotid arteries are paired arteries on each side of the neck that supply blood to the
brain and face. There are two carotid arteries on each side of the neck (the internal and
external carotid arteries). The internal carotid artery supplies blood to the brain and
the external carotid artery supplies blood to the neck, face and scalp. The vertebral
arteries another set of paired arteries supply blood to the brain and travel there in the
back of the neck. Therefore, there are four arteries that supply blood to the brain: the
right and left internal carotid arteries and the right and left vertebral arteries.
How
Can Carotid Artery Disease Cause Strokes?
A
stroke generally refers to irreversible damage in a portion of the brain due to a lack of
adequate blood flow. If one of the carotid arteries supplying blood to the brain is
occluded (blocked), that portion of the brain may be affected. Similarly, if the carotid
arteries contain a significant amount of plaque (narrowing) small pieces of this plaque or
newly formed blood clots can break free and become lodged in a small brain artery causing
symptoms of a stroke.
Where
Are Risk Factors for the Development of Carotid Artery Problems?
The
risk factors for carotid artery disease are the same as those for other conditions of
arteriosclerosis. These include, but are not limited to, genetic predisposition, smoking,
diabetes mellitus, hypercholesterolemia (high levels of cholesterol), obesity and diet.
How
is Carotid Artery Disease Diagnosed?
Most
disease of the carotid artery is diagnosed with noninvasive means by Duplex Ultrasound
examination. However, it is imperative that the technologist be very familiar with the
appropriate methods to perform this test since slight differences in technique can produce
vastly different results. Assurance that a laboratory is proficient in this type of study
is documented by its achieving accreditation from the ICAVL
a national regulatory body responsible for assuring quality of Noninvasive Vascular
Laboratories.
What
are the Signs of Carotid Artery Disease?
Most
disease of the carotid arteries is asymptomatic (silent; without symptoms.) Often an
abnormal sound heard with the stethoscope will prompt a physician to order the carotid
ultrasound study. It is possible for a person to have a transient ischemic attack
(mini-stroke) that produces only temporary symptoms that last for less than 24 hours.
These are usually symptoms of weakness of an arm or leg or slurred speech that resolves
quickly. A stroke can also be a sign of carotid artery disease but not all strokes are due
to diseases in these arteries.
Must
All Carotid Artery Disease Be Treated?
NO!
The decision to treat narrowing of the carotid artery is not always straightforward. The
risks of the surgery (taking into account the particular surgeon's experience) must be
weighed against the potential benefit of the surgery. The degree of narrowing of the
carotid artery and the presence or absence of symptoms are some of the important factors
to consider when deciding on a therapeutic approach.
How
are Carotid Artery Problems Treated?
There
are two
primary interventions for carotid artery disease: Carotid
Angioplasty with Stent placement (CAS) and a surgical carotid endarterectomy
(CEA). Both aim to reduce the degree of narrowing in the carotid
artery thereby reducing the chance of stroke. CAS acts by compacting the
plaque and keeping the artery open with a metal device called a 'stent." CEA
accomplishes the task by removing the plaque completely from the artery and
widening the artery with the use of a "patch" to reduce the chance of the artery
"renarrowing." The two techniques have their own proponents with
sufficient evidence to support either method. The Cardiovascular
Care Group offers both techniques and will suggest the one that is best suited
for the particular patient. Patients who are deemed to be at a high risk for a
either procedure may be placed on medications to inhibit their blood from clotting.
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