The carotid arteries are two essential blood vessels on each side of your neck and carry oxygen-rich blood from your heart to your brain. Over time, these arteries can become narrow or blocked by a buildup of plaque — a mix of fat, cholesterol, and other substances.
This condition, carotid artery stenosis, affects around 58 million people worldwide. It’s also a common problem in many patients at Vascular Surgery Associates.
When the carotid arteries narrow, blood flow to the brain slows down, increasing the risk of a stroke — a serious medical emergency where part of the brain doesn’t get enough blood. Because of this, treating carotid artery stenosis is crucial to prevent life-threatening problems.
Many people are unaware they have carotid artery stenosis because it often causes no symptoms. Studies estimate that 0.1% of men under 50 have severe asymptomatic carotid stenosis (ACS), increasing to 3.1% of those 80 and over, so screening is also a vital part of our work.
The vast majority of patients who have a carotid artery stenosis do not require surgery. Their treatment consists of medical therapy and change in lifestyle. With these interventions their risk is stroke is very low and chances of progressing to surgery is minimal.
For many years, surgeons have relied on two main treatments for carotid artery stenosis: carotid endarterectomy (CEA) and carotid artery stenting (CAS).
CEA surgery is where we make an incision in the neck, open the affected artery, and remove the plaque buildup. This is one of the most refined and well studied surgeries in clinical medicine. Patients treated by experienced surgeons have an extremely low risk of complications and most only spend a single night in the hospital.
CAS is a less invasive option. Using a thin, flexible pipe (catheter), we place a small mesh tube (stent) inside the artery. The stent helps keep the artery open and improves blood flow to the brain.
Both treatments have saved countless lives and remain excellent choices for many patients today. But now, we have even more advanced tools and techniques.
Medical research never stops, and that’s beneficial news for patients. Here are some of the latest updates you should know about:
One of the most exciting advances in recent years is transcarotid artery revascularization (TCAR). This minimally invasive procedure combines the best parts of surgery and stenting while reducing the risks of traditional methods.
With TCAR, we make a small incision just above the collarbone and place a tube directly into the carotid artery. Before placing the stent, we temporarily reverse the blood flow away from the brain, which helps protect against any plaque fragments that could cause a stroke. After the stent is securely in place, we restore normal blood flow.
TCAR is especially helpful for patients with a higher risk of complications from traditional surgery, such as older adults or people with heart problems. Recovery is often faster, and many patients return home the next day.
Your Vascular Surgery Associates team was the first private group in Maryland to do over 100 of these procedures. They have now done over 500 and have several partners who have been involved in carotid stent trials during their careers.
Newer stents are more flexible and durable, which makes them better suited to the carotid artery’s twists and turns. These improvements lower the chances of the artery narrowing again (a condition called restenosis) and help keep blood flowing smoothly for years to come.
Before we treat carotid artery stenosis, it’s crucial to have a clear picture of what’s happening inside your arteries. Advances in imaging technology, like high-resolution carotid duplex and CT angiography, give us detailed views of your blood vessels, allowing us to plan treatments with greater precision and safety.
Whether you’re a candidate for TCAR, traditional surgery, or stenting, we can guide you through every step and help you make informed decisions to suit your needs and lifestyle.
Carotid artery stenosis is a serious condition, but it’s also one we understand well and can treat effectively. Thanks to recent medical advances, you have more choices than ever before. If you or a loved one has been diagnosed with carotid artery stenosis, reach out to our team today by phone or via the online inquiry form.
