Carotid Artery Stenosis - Diagnosis & Treatment

How is carotid artery stenosis diagnosed?

Your doctor may inquire about your medical history and perform a physical exam. A stethoscope will be placed over the carotid arteries on both sides of your neck, and your doctor will listen for a sound that indicates the presence of narrowing.

Then, your doctor may order imaging tests to confirm a diagnosis and learn more about the severity of the narrowing or location of the blockage. These tests include ultrasound, computed tomography angiography and magnetic resonance angiography.

How is carotid artery stenosis treated?

Treatment is aimed at slowing the progression of carotid artery stenosis and the development of stroke. This begins with lifestyle modifications such as quitting smoking, losing weight, working out regularly, eating healthy foods, and reducing salt intake.

If you have mild stenosis, you may be given blood thinners such as antiplatelet drugs (aspirin or clopidogrel) to prevent the formation and growth of clots. You may also be prescribed anti-hypertensive drugs and cholesterol-lowering medications such as statins.

In more severe cases, you may undergo surgery to remove the plaque. Surgical treatments options include:

• Carotid endarterectomy. Your surgeon makes a small cut along the front of the neck to open the affected carotid artery and remove the plaques. Your artery is mended with either stitches or a graft.
• Carotid artery angioplasty with stenting. This procedure is minimally invasive and offered to patients who are unable to have carotid endarterectomy. During the procedure, your surgeon inserts a catheter through a blood vessel in your groin. The catheter is then threaded to the carotid artery in your neck. Next, a small balloon is inflated to hold open the artery and allow the placement of a stent – a thin, metal-mesh material that functions to hold the artery permanently open.