Carotid Artery Disease

Probably the most feared complication of atherosclerosis is stroke. Although there are several forms of stroke, one common form results from blockage or stenosis of the carotid artery. The carotid artery in the neck is unusually susceptible to plaque deposition. As the plague builds, blood flow to the brain is restricted. The plaque can thrombose which means clot off completely, or it can hemorrhage and embolize, sending little particles to the brain. Sometimes a noise in the neck, called a bruit might be heard, but most patients with carotid blockage have no signs or symptoms. The first symptom may be a stroke or a mini-stroke sometimes referred to as a “TIA.” TIA is a transient ischemic attack caused by a tiny piece of plaque breaking off the carotid and traveling to the brain. The affected part of the brain loses oxygen supply which produces neurologic symptoms. Symptoms of a TIA can include slurred speech, facial weakness or droop, paralysis or numbness of an extremity, or temporary loss of vision in one eye. Significant stenosis of the carotid artery can be diagnosed with a non-invasive carotid duplex scan (ultrasound). If high grade >70% stenosis is found, then you may benefit from carotid endarterectomy, a surgical procedure designed to clean out the plaque. It is the most studied surgical procedure in medical history and has been proven over and over to be a safe effective way to prevent stroke in patients with severe carotid occlusive disease. Dr. Tapper trained with one of the pioneers of carotid surgery and his technique has been honed over the course of thousands of operations. One key to Dr. Tapper’s success with carotid endarterectomy is that he places a shunt in every patient while he is working on the artery. A shunt keeps blood flowing to the brain while he works under microscopic lenses to thoroughly clean out the artery. His stroke rate of 0.75% is far better than the national average. 

Click here to to learn more about carotid disease from the NIH.