The neurosurgeons at Houston Methodist Hospital Neurological Institute Cerebrovascular Center diagnose and treat many kinds of cerebrovascular conditions, including carotid atherosclerotic disease.
The carotid arteries in your neck deliver blood to the brain. Over time, plaque (cholesterol, fatty deposits and other materials) can build up in the carotid arteries, causing them to narrow and harden. This is called carotid atherosclerotic disease, carotid atherosclerotic stenosis, carotid artery disease, or “hardening of the arteries.” If the narrowing is severe enough to restrict blood flow to the brain, it can cause a stroke.
If a diseased carotid artery cracks or ruptures (bursts), this can cause blood to leak and form a clot, which can block blood flow and cause a stroke. Sometimes plaque can also break loose, block an artery in the brain, and cause a stroke.
Atherosclerosis is the most common cause of artery disease. It usually progresses slowly. Risk factors for carotid atherosclerosis disease include:
Carotid artery disease usually doesn’t cause any symptoms until the arteries are narrow enough to reduce the blood flow to the brain. However, sometimes even narrow arteries don’t cause symptoms. Because this disease often progresses without symptoms, the first signs may be serious, such as a transient ischemic attack (TIA or mini stroke) or stroke. TIA and stroke symptoms may include:
In addition to a physical exam, several tests can help determine whether you have carotid atherosclerosis disease.
If you are diagnosed with carotid atherosclerotic disease, our team of specialists will work with you to develop a personalized treatment plan based on the degree of your stenosis, your symptoms, and your overall health.
Houston Methodist offers both carotid endarterectomy, and angioplasty and stenting to treat carotid atherosclerosis.
A carotid endarterectomy (CEA) procedure can restore blood flow and lower the risk of having a stroke. During this surgery, a neurosurgeon makes a small incision in your neck and removes the inner lining of your carotid artery that contains the plaque. Sometimes the doctor makes a patch to widen the artery. This can be done using part of another vein or a synthetic material.
CEA may or may not be right for you depending on:
Carotid stenting often begins with a balloon angioplasty, where a surgeon inserts a balloon-tipped catheter into your artery to widen it and flatten the plaque. Then a stent (mesh tube) is placed to keep the artery open and allow more blood to flow through. This minimally invasive procedure is a better treatment option for some people, especially if they are not good candidates for carotid endarterectomy.
After a carotid endarterectomy or stenting procedure, you will be taken to a recovery room until you wake up and your vital signs (blood pressure, breathing rate) are stable. Then you will be taken to a regular hospital room or intensive care unit (ICU) room to further recover. Most patients are able to leave the hospital within a day or two.
When you return home, make sure to follow your surgeon’s advice about returning to your normal activities, taking care of the insertion site, and watching out for any warning signs such as fever, chills, unusual pain, or bleeding or swelling at the insertion site. You may need to have periodic exams or ultrasounds so your doctors can monitor your condition.