Carotid Artery Disease

The carotid arteries are major blood vessels that supply oxygenated blood to the head, neck and brain. Over time, arteries can harden and narrow — a condition called atherosclerosis — due to the buildup of cholesterol and fatty deposits, known as plaque. If the carotid arteries narrow enough to restrict blood flow to the brain, it can cause a stroke, and if blood flow to the heart is blocked, it can result in a heart attack. Diseased carotid arteries can also crack or rupture, causing blood to leak, clot and clog the arteries.

Patients with atherosclerosis are more likely to develop carotid artery disease. Risk factors include the following conditions: 

  • Advanced age 
  • Smoking 
  • Diabetes 
  • Obesity 
  • High-fat diet 
  • Family history and genetic factors 
  • High blood pressure (hypertension) 
  • Elevated fats in the blood (hyperlipidemia)


Diagnosing Carotid Artery Disease
Patients with known risk factors or known atherosclerosis can have several tests to determine whether carotid artery disease is present.

  • Duplex or doppler ultrasound uses sound waves to measure how fast your blood flows and to determine where there is narrowing or blockage in the artery.
  • Computed tomography (CT) scans takes images of brain tissue and are often used to rule out bleeding or other problems.
  • Computed tomography angiogram combines the use of an injectable contrast dye to highlight the carotid arteries with a scan of the head and neck to look for possible narrowing or blockages.
  • Magnetic resonance imaging (MRI) uses magnetic and radio waves to create images of brain tissue to look for signs of an early stroke or other problems.
  • Magnetic resonance angiography uses contrast (dye is injected) combined with MRI to create cross-sectional and 3-D images of the arteries.
  • Cerebral angiogram is a procedure where the surgeon threads a catheter into the carotid arteries and injects contrast to help the arteries show up on detailed X-rays.


Treating Carotid Artery Disease
Houston Methodist physicians work with patients to determine the best course of treatment for carotid artery disease. Carotid endarterectomy and stenting are two common procedures.

In a carotid endarterectomy procedure a small incision is made in your neck, and the surgeon removes the inner lining of your carotid artery that contains the plaque. Depending on your health status, the doctor may make a patch to widen the artery.
Carotid stenting often begins with a balloon angioplasty. The surgeon inserts a balloon-tipped catheter into your artery, usually through your arm or leg, to widen it and flatten the plaque. Then a stent (mesh tube) is inserted in the artery to keep the passage open and allow more blood to flow.


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