Disease of the carotid arteries involves the build up of plaque (atherosclerosis) in the arteries that provide blood to the brain. This plaque is similar to what can occur in the heart and other arteries. This usually occurs over the course of many years as the result of medical problems, poor diet, and genetic factors.
The most feared complication of carotid artery disease is stroke. A stroke involves lack of blood flow to part of the brain which usually causes difficulty moving one side of the body or an inability to talk. When these symptoms resolve within 24 hours the problem is called a “transient ischemic attack” or TIA. Some people refer to these as “mini strokes”. Not all strokes or TIAs are related to carotid artery disease. Your physician needs to determine the cause. Some people have significant carotid disease that may or may not require surgical treatment without any symptoms at all.
If however, it is determined that the reason for the stroke or TIA is indeed carotid plaque this necessitates treatment. The two most common treatment types are open surgery or carotid stenting. Currently, carotid stenting is only approved for those patients who have had a stroke or TIA and severe medical disease. There are several kinds of stents available. Dr. Kazil took part in the recent ROADSTER II trial featuring an innovative stent delivery system. She plans to bring this technique to Florida in the near future.
Open carotid surgery involves creating a two to three inch incision along the neck. The surgeon then opens the artery, removes the plaque and sews a patch back on the artery prior to closing the skin. Patients stay overnight in the hospital to watch for any changes in neurologic function or blood pressure issues. They usually go home the next day and are back to work within a few days.