Medically Reviewed by Joshua A. Sibille, MD

Clogged arteries that feed our brain present a serious danger of stroke and even death.  McLeod Vascular Specialist Dr. Joshua Sibille explains the cause and treatments for carotid artery disease.

Here’s a summary of Dr. Sibille’s comments:

The carotid arteries are a pair of arteries in the neck that supply blood to the brain. They’re very important, because they’re a common source of buildup of plaque which can cause carotid stenosis. If this gets severe enough, a person experiences a higher risk of stroke.

Most patients with carotid artery disease have no symptoms. For most patients, the problem is found by their physician during a physical exam. When listening to the arteries, the doctor hears something called “bruit” (BROO-ay), which is an abnormal noise in the neck. From here, an ultrasound is performed, which can show the blockages in the neck. Patients can also present with a stroke or stroke-like symptoms and, in the process of working it up, are found to have carotid artery stenosis.

The initial workup for any type of carotid artery disease is usually an ultrasound. It’s very simple and can be done as an outpatient. Confirmatory tests usually include a CT angiogram, an MRI or a full angiogram itself.

Carotid artery stenosis is broken down by degree of stenosis. When the degree of stenosis reaches a critical percentage, usually about 70%, we do recommend interventions for patients that can significantly reduce their long-term risk of stroke. Patients, who have mild or moderate stenosis  and have no symptoms, are typically treated with a combination of medicines, including antiplatelet medications, such as aspirin, and cholesterol medicines, such as statins. Statins are a class of cholesterol medication that have been well studied and have been shown to reduce the risk of overall cardiovascular morbidity and mortality. It can reduce your risk for stroke and heart attack as well.

We also recommend modifying risk factors, including stopping smoking, as well as adequate diabetes and high blood pressure control.

In patients who do have carotid artery disease requiring treatment, there are several options. The classic treatment is surgery, where we open the artery, clean out the plaque and close it back. Other options include stenting, where we go in either through the groin or through a small incision at the base of the neck and place a stent across the blockage to keep it open.

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