Carotid Artery Disease Treatment

Stroke-like symptoms, like dizziness, weakness on one side of your body, or problems seeing straight are definite causes of alarm. These could be signs you have carotid artery disease.

Carotid artery disease happens when one or both of your carotid arteries become narrowed or blocked. The carotid arteries carry blood from the aorta through the neck to the brain.

Plaque buildup in the carotid arteries cuts off blood flow to the brain and is a major cause of stroke. 

A stroke can also occur when:

• Plaque in the artery ruptures and blood cell fragments (platelets) clump together to form blood clots. These blood clots can partly or fully block a carotid artery.
• A piece of plaque or blood clot breaks away from the carotid artery wall, travels through the bloodstream, and gets stuck in one of the brain's smaller arteries, blocking blood flow. 

Treating Carotid Artery Disease at UVA Health

At UVA Health, we can check if you have carotid artery disease by using these tests:

• Ultrasound
• Computed tomography (CT) scan 
• Magnetic resonance angiography (MRA)
• Angiography

If you do have it, we can work with you to choose the right treatment. 

If the blockage isn't too bad, you may need medication or some heart-healthy lifestyle changes. For more severe blockages, you may need one of the following.

Carotid Endarterectomy (CEA)

UVA Health performs about 120 CEAs each year. Patients do better at hospitals that have more than 100 CEAs per year. CEA is a surgery that improves blood flow. Your surgeon opens your carotid artery and removes the plaque causing the problem.

Transfemoral Carotid Angioplasty & Stenting (TF-CAS)

TF-CAS may be the right procedure for you if you're not a good candidate for CEA or open surgery. Through this minimally invasive procedure, your surgeon places a tube in a thigh artery. A filter, placed beyond the carotid artery blockage, keeps fragments of plaque from traveling to your brain during the procedure. 

Your surgeon puts a catheter with a balloon on its tip into your artery and threads it to the blocked or narrowed carotid artery. The balloon inflates and pushes the plaque to the artery walls to open it up. A stent helps keep the artery open.

TransCarotid Artery Revascularization (TCAR)

TransCarotid Artery Revascularization (TCAR) is a minimally invasive technique that, in some cases, appears to reduce some of the risks of CEA and/or TF-CAS. It can be done under local or general anesthesia.

Your surgeon makes a small cut just above your collarbone and puts a tube into your carotid artery. The tube connects to a system that sends blood flow away from the brain to keep loose plaque from reaching your brain. The blood flows through the system, and a filter outside of the body captures any plaque that has come loose.

The filtered blood returns through a second tube in the upper leg. Once your surgeon places the stent and turns off blood flow reversal, your blood flow resumes in a normal direction.