Carotid Artery Disease

Melanie Nukala, MD, vascular surgeon, discusses carotid artery disease.

What is carotid artery disease?

The carotid arteries can get blockages just like the heart or legs. Smoking, high blood pressure, and high cholesterol are the biggest risk factors for carotid arteries. Patients don't always know that they have carotid arteries unless they have a family history. In those cases, sometimes they're a little more attuned to the problem. Otherwise, sometimes a primary care physician will hear a bruit (whistling sound) in the neck with their stethoscope. Then, they will send the patient to get an ultrasound of the carotid arteries. More commonly, a lot of patients will come in having had a stroke or a mini-stroke, and during the full workup, we'll find out that they've got blockages that need to be addressed.

How do you address carotid artery disease?

Obviously, if they have a stroke or a mini-stroke and they have blockages in the carotid arteries that would be something that we need to fix. We can do that via an open procedure or a stent placement. An open procedure (carotid endarterectomy) is where you make an incision in the neck and actually clean out the carotid artery. One of the newer procedures that we do is a stent placement where we cut down on the carotid artery at the lower portion of the neck and actually deliver a stent right through there. One of the older ways to do a stent would be from a groin artery, but we're getting more away from that now as we are able to put the stent straight through the carotid artery itself.