Carotid Artery Disease

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

Plaque build up 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, travel through the bloodstream and get stuck in one of the brain's smaller arteries, blocking blood flow. 

Artery Blockage Increasing Risk of a Stroke

The carotid artery carries blood through the neck to the brain. When plaque builds up in the arteries, it increases the risk of a stroke. W. Darrin Clouse, MD, discusses the causes, symptoms and treatment. View carotid artery disease transcript.

Risk Factors for Carotid Artery Disease

Risk factors for this disease include:

  • Diabetes
  • Family history of atherosclerosis
  • High blood pressure
  • Lack of physical activity
  • Metabolic syndrome
  • Older age
  • Obesity
  • Smoking
  • High cholesterol
  • Unhealthy diet

Diagnosis & Treatment at UVA

At UVA, we can diagnose you by using these tests:

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

    Your healthcare provider can work with you to choose an appropriate treatment. 

    For a moderate blockage, you may need medication or to begin making heart-healthy lifestyle changes. For more severe blockages, you may need one of the following. 

    Carotid Endarterectomy (CEA)

    UVA performs about 120 CEAs each year. Patient outcomes are better at hospitals that perform more than 100 CEAs annually. CEA is a surgical procedure that removes the plaque causing the narrowing or blockage. Your surgeon opens the carotid artery and improves blood flow.

    Transfemoral Carotid Angioplasty and Stenting (TF-CAS)

    TF-CAS may be the right procedure for you if you're ineligible for CEA or are at high risk for an open surgery. Through this minimally invasive procedure, your surgeon places a tube in a thigh artery. A filter, placed beyond the carotid artery blockage, limits any fragments of plaque traveling toward the brain throughout the procedure. 

    Your surgeon inserts a catheter with a balloon on its tip 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 newer, minimally-invasive technique that in some cases appears to reduce some of the risks of CEA and/or TF-CAS. It can be performed under local or general anesthesia.

    Your surgeon makes a small incision just above your collarbone and inserts a tube into the carotid artery. The tube connects to a system that directs blood flow away from the brain to protect loose plaque from reaching the brain. The blood flows through the system, and a filter outside of the body captures any material that has comes 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. 

    Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.