Carotid Artery Disease - Empire Vein & Vascular Specialists

Stroke is the fifth leading cause of death and the number one cause of disability in the United States, according to the American Stroke Association. Carotid artery disease is a major underlying cause of stroke, impacting up to 5% of the population. Early detection and advanced treatment options can significantly reduce the risk of stroke.

What is Carotid Artery Disease?

Your carotid arteries are the two main arteries that carry blood from your heart, up through your neck, and into your brain. Healthy carotid arteries are smooth and unobstructed, allowing blood to flow freely to the brain. They provide oxygen, glucose (sugar), and other nutrients your brain cells need to function optimally.

As you age, the carotid arteries may build up plaque, which is a fatty deposit made up mostly of fat and cholesterol. This plaque narrows the insides of the arteries, making them stiff. The build-up of plaque is commonly referred to as “hardening of the arteries” or atherosclerosis. This narrowing, known as carotid artery stenosis, can restrict blood flow and increase the risk of stroke.

Who is at Risk?

Carotid artery stenosis can increase your risk of a Transient Ischemic Attack (TIA) or mini-stroke, and is the most common cause of stroke.

Risk factors of carotid artery stenosis and stroke include:

Age above 65 years old
Diabetes
High cholesterol
High blood pressure (hypertension)
Smoking
Coronary artery disease (heart disease)
Obesity
Lack of exercise

Symptoms and Diagnosis

Signs of carotid artery disease may include a transient ischemic attack (TIA), which is an early indicator of carotid stenosis. A TIA typically resolves within 24 hours without long-term effects. These temporary episodes are warning signs and predict an increased risk of future stroke. Strokes can occur when blood flow to the brain becomes severely restricted or completely blocked due to carotid artery narrowing. It’s important to note that carotid stenosis may progress silently, and in some cases, a stroke might be the first sign of the disease.

Symptoms of a stroke include:

Numbness on one side of your body
Weakness, paralysis, or loss of coordination on one side of your body
Drooping on one side of your face or mouth
Blindness or loss of part of the vision in one eye that typically is described as a shade being drawn over an eye
Loss of speech or garbled speech
The inability to write or understand writing
Episodes of memory loss

If you or a loved one experiences any of these symptoms, you must call 911 and visit your closest emergency room for immediate medical attention.

Typically, a diagnosis will start with a physical exam and evaluation of your medical history. Your doctor will listen to the artery on your neck with a stethoscope to try to hear a noise called a bruit, which is the whistling sound the blood makes when it passes through a blocked artery.

Diagnosis is often made through a Doppler ultrasound, magnetic resonance angiography (MRA), or arteriogram.

The type of test for carotid artery disease you need to evaluate the condition of your carotid arteries and risk factors for stroke will be determined by your vascular surgeon.

TCAR – The Gold Standard for Carotid Artery Treatment

TransCarotid Artery Revascularization (TCAR) is a novel technique reducing stroke risk for high-risk patients by minimizing surgical risks and diverting plaque away from the brain using a proprietary device. It is one of the state-of-the-art carotid artery stenosis treatments offered by Empire Vein and Vascular Specialists.

The procedure takes less than half the time of a carotid endarterectomy. It does not require general anesthesia, which limits stress on the heart and significantly reduces the risk of having a stroke or heart attack during the procedure.

Summary of the Procedure and Recovery

The TCAR procedure avoids the risks of general anesthesia, lowering the risk of stroke, which can happen with other procedures. A TCAR is performed by a vascular surgeon at the hospital and takes about an hour to complete.

A small incision is made at the base of the neck, through which a specialized system temporarily reverses blood flow to divert plaque debris away from the brain. A stent is then precisely placed within the narrowed carotid artery to restore normal blood flow, ensuring long-term patency.

Patients are usually discharged in 24 hours and have a quick recovery. It is quickly becoming the preferred method of treatment for carotid disease. Empire Vein and Vascular Specialists has performed more TCAR procedures than any other vascular practice in California.

Why Choose Empire Vein and Vascular Specialists?

At Empire Vein and Vascular Specialists, we collectively have over 30 years of experience in treating carotid artery disease and have performed more than 500 procedures for carotid stenosis. Our team is one of the top five most experienced in the country in TCAR, with outstanding patient outcomes.

Our board-certified vascular surgeons are uniquely trained and experienced to offer all forms of carotid artery disease treatment, ensuring that each patient receives the most appropriate care for their specific condition.

FAQ & Next Steps

If you are concerned about carotid stenosis or your risk of stroke, start by discussing your concerns with your physician, who will take a detailed history and exam. If you have risk factors for carotid disease, they can order a noninvasive test known as a carotid ultrasound to detect plaque buildup in the artery.

No, surgery is not required for all patients who have carotid stenosis, and even if they do, it is rarely an emergency. If you have carotid stenosis, you will likely be referred to a vascular surgeon, a specialist in the diagnosis and treatment of this condition. Only patients with a significant amount of plaque buildup (usually 75% or greater) or recent symptoms of a mini-stroke, known as a TIA (Transient Ischemic Attack) or a stroke, will be recommended for surgery.

A board-certified vascular surgeon is uniquely qualified to treat carotid artery stenosis. They have the experience and access to multiple treatment options, including surgery (carotid endarterectomy) and minimally invasive options, such as carotid stent and TCAR. A vascular surgeon will evaluate your health history and recommend the best treatment for you.

Trans carotid artery revascularization (TCAR) is an excellent minimally invasive option for the treatment of carotid artery stenosis. The procedure avoids the risks of general anesthesia, lowering the risk of stroke, which can happen with other procedures.

A TCAR is performed by a vascular surgeon at the hospital and takes about an hour to complete. It involves making a very small incision at the base of the neck. Patients are usually discharged in 24 hours and have a quick recovery. It is quickly becoming the preferred method of treatment for carotid disease.

On-going follow-up and surveillance after the procedure is important for long-term success. Your vascular surgery team will arrange for follow-up ultrasounds every six months to monitor the stent and look for signs of blockage recurrence.

At Empire Vein and Vascular Specialists, we collectively have over 30 years of experience in treating carotid artery disease and have performed more than 500 procedures for carotid stenosis. In addition, we are one of the nationwide leaders in the TCAR minimally invasive procedure for carotid artery stenosis.

Schedule a Consultation Today for expert carotid artery care.

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