Understand the Disease and Treatment Options
Your carotid arteries are a pair of blood vessels in your neck that carry blood from your heart to your head and brain. These vessels can become narrowed or blocked by a buildup of plaque called a stenosis. A stenosis may lead to a stroke, which happens when blood flow to a part of the brain is stopped. A stroke is sometimes called a “brain attack.” If blood flow is stopped for longer than a few seconds, the brain cannot get blood and oxygen. Brain cells can die, causing permanent damage.
Treatment options for carotid artery disease depend upon the severity of the overall patient condition and symptoms. Moderate disease may not require a procedure. More severe blockages may require treatment with surgery, called carotid endarterectomy (CEA), or with a stent. To learn more about these options, please visit the links below.
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How Can Carotid Artery Disease be Treated?
The treatment of carotid artery disease depends upon the severity of your condition and your symptoms. If your stenosis is moderate and you are able to attain and maintain a healthy weight, blood pressure, cholesterol level, and blood sugar level, you may be able to avoid surgery. Regular exercise, a diet that is low in salt, saturated fats, cholesterol, and trans fats, and quitting smoking can all be helpful. Your doctor may also prescribe medications to keep your blood from clotting which may help prevent a stroke.
Treatment Options for Severe Blockages
The most common treatment for severe carotid artery disease is a surgery called Carotid Endarterectomy (CEA). Your surgeon will make an incision on your neck to access the aﬀected artery, open it and remove the plaque. Your surgeon will then close the artery and the incision in your neck using stitches.
Transfemoral Carotid Angioplasty and Stenting
There are situations where a CEA cannot be performed, for example if you have other health conditions that make surgery too risky. Another option is a procedure called transfemoral carotid angioplasty and stenting (CAS). This minimally invasive alternative allows your physician to complete the procedure through a tube placed into the artery in your thigh.
First, a protection device is placed next to the diseased area of the vessel, to help prevent any pieces of plaque from traveling towards your brain. Then, a small balloon is advanced to the narrowed part of your artery. Your surgeon will inflate the balloon, compressing the plaque, and then place a small elastic-like scaﬀold tube called a stent in order to cover the plaque and keep the artery open. Widening the narrowed portion of the artery may reduce the risk of stroke in the future.
The TCAR Procedure: TransCarotid Artery Revascularization
A potential complication of both surgery and stenting is a stroke during the procedure itself. Studies have shown a higher risk of stroke during stenting as compared to surgery. The TCAR Procedure using the ENROUTE® Transcarotid Neuroprotection System is designed to reduce the risk of stroke while inserting the ENROUTE Transcarotid Stent. The TCAR procedure is performed through a small incision at your neckline just above your clavicle. This incision is much smaller than a typical CEA incision.
Your surgeon will place a tube directly into your carotid artery and connect it to a system that will direct blood flow away from your brain, to protect against plaque that may come loose reaching your brain. Your blood will flow through the system and any material will be captured in a filter. Your filtered blood will then be returned through a second tube in your upper leg. After the stent is placed successfully, flow reversal is turned oﬀ and blood flow resumes in its normal direction.