Carotid Artery Disease
The carotid arteries are blood vessels that carry blood from the heart up to your head and brain. You can normally find them by placing your fingers on your neck on either side of your windpipe.
Carotid Artery Disease happens when plaque (atherosclerosis) starts to build up in the carotid arteries. If left untreated, patients could have a stroke, which is when a piece of plaque or a blood clot blocks the carotid artery to the brain, or part of this disease breaks off and travels up into the brain blocking the smaller blood vessels there. They may also develop a TIA (Transient Ischaemic Attack) which is a small stroke that normally resolves within 24 hours. TIA's can often be a warning that a more major stroke is imminent.
The main causes for carotid artery disease can either be fixed, such as gender - males are at higher risk, a family history of stroke or age - the majority of strokes happen over the age of 55, and risk increases with age. However, there are also other factors such as high cholesterol, high blood pressure or diabetes.
It is quite possible that you can have carotid artery disease and not have any symptoms. Normally, patients will present having had a TIA (mini stroke). The symptoms from this normally present including weakness to the face or arms, and speech problems. You may have seen the FAST campaign asking to look out for Facial weakness, Arm weakness, Speech changes, Time.
The best way to treat Carotid Artery Disease by stopping smoking, doing exercise and maintaining a healthy diet. We can also look to treat with both medication and surgery:
All patients with carotid artery disease should take anti-platelet medication which will help to stop platelets sticking together and reduce complications. The most common anti-platelet medication is aspirin. Patients may also be prescribed with Clopidogrel or in some cases warfarin which will help to reduce blood clots.
If the narrowing of the carotid artery is significant, you may need to have the artery opened and the blockage, removed which will increase the flow of blood to the brain. This can be one of 2 ways:
- Carotid Endarterectomy – This is generally performed under either general and local anesthesia (sedation) and involves making an incision in your neck. The diseased area of artery is identified and the plaque is removed from the artery. The artery is then stitched up, often with a small patch to widen it slightly, and blood can flow freely to the brain once more.
- Carotid Angioplasty & Stenting – This is performed under local anesthesia (sedation). A guide wire with a tiny balloon is inserted into the main artery in the groin and fed up through the body to the artery in the neck. This is placed into the narrowed part of the vessel and is then gently inflated to open up the narrowing. A stent (a flexible metal tube) may also be placed to help keep the artery open.
With both treatments, you probably require an overnight stay in hospital. You are normally able to return to normal activities after a few weeks.
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