Carotid Artery Disease

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Can carotid artery disease be prevented?

Prevention is the cornerstone for treating carotid artery disease. Like any other blood vessel in the body, carotid arteries are at risk for narrowing in individuals who smoke, have high blood pressure, high cholesterol, have diabetes or have a history of heart attack or stroke.

  • Living a healthy life-style includes eating a well-balanced diet, maintaining an appropriate weight for your height, and exercising routinely.
  • Smoking increases the risk for carotid artery disease and stopping smoking is beneficial, even at an older age.
  • Lifelong control of high blood pressure, cholesterol, and blood sugars will decrease the risk of developing carotid artery disease.

What is the prognosis for carotid artery disease?

Many individuals have some narrowing of their carotid arteries and have no symptoms.

There are benefits and risks for both medical and surgical management of carotid artery disease. The decision as to which treatment is offered depends upon the age of the patient, their neurologic status, their other underlying medical conditions, and the degree of carotid artery narrowing.

The purpose of treatment is to reduce the risk of stroke. In patients whose treatment recommendation includes antiplatelet medications associated with blood pressure, cholesterol, and diabetes control, the risk of stroke after 2 years may be as low as 11%. For patients who qualify for surgery, their risk can fall to 2%-5%, but there are associated surgery risks including stroke, cranial nerve paralysis with hoarseness and difficulty swallowing, and restenosis or renarrowing of the artery.

The doctor needs to discuss the benefits and risks of treatment to tailor the recommendations to the individual patient's needs.

Medically reviewed by Robert J. Bryg, MD; Board Certified Internal Medicine with subspecialty in Cardiovascular Disease

REFERENCES:

Brott TG, et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. Jul 1 2010;363(1).

Marx J, et al. Rosen's Emergency Medicine Concepts and Clinical Practice. 8th edition. Saunders. 2013.

Medically Reviewed by a Doctor on 11/5/2015

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