The treatment for carotid artery disease depends on the severity, the symptoms you have experienced, and your overall state of health. Mild or moderate stenosis may be treated with medication and by reducing as many risk factors as possible to slow the growth of the stenosis. Your healthcare provider will discuss the importance of reducing your risk factors and regular medical follow-up.
More severe carotid artery stenosis may sometimes be treated with an operation know as carotid endarterectomy (CEA). This is a surgical procedure in which the plaque and inner lining of the artery is removed. An incision is made, the carotid arteries are located; clamps are placed above and below the surgical site; the carotid artery is opened; and the plaque is carefully removed. The artery is then closed with a patch of a vein or an artificial/synthetic material; sutures or staples are applied to the skin and the area is covered with a dressing. In certain instances, it may be possible to treat carotid stenosis through catheters inserted in the groin with stents placed in the carotid artery to improve the flow through the region. This approach is very new and the devices have only recently been approved for use by the FDA. As the technology develops, more and more patients will be candidates for this procedure.
We offer TransCarotid Artery Revascularization, or TCAR, a minimally invasive procedure for patients with carotid artery disease. TCAR is a less invasive alternative to a carotid endarterectomy (CEA), the procedure that is most commonly used to treat severe carotid artery disease. CEA starts with a three to four inch incision at the front of the neck, where TCAR gains direct access to the common carotid artery through a much smaller incision above the collarbone, allowing just enough room to place a sheath into the artery and place a stent. The stent is then inserted in the artery to open and stabilize the narrowing and help protect patients from future stroke risk. Throughout the procedure, blood flow is temporarily reversed in the carotid artery to divert dangerous debris away from the brain, preventing a procedural stroke.
The best treatment for carotid artery disease depends on a number of factors, including the size and location of the stenosis, whether or not it is causing symptoms, and the age and general health of the patient. You should discuss all of these factors and any other questions you have with your primary care physician.