What is Carotid Stenosis?
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Carotid stenosis is a narrowing of the carotid arteries, the two large arteries responsible for carrying oxygen-rich blood to the brain. The narrowing is caused by a buildup of atherosclerotic plaque in the arteries. When the blockage prevents blood from reaching parts of the brain, causing shortages of oxygen, it can result in transient ischemic attacks (TIAs) or a stroke. Clots that may form on narrowing portions of the arteries can break off and also cause TIAs or stroke.
Why rely on Washington University experts to treat your carotid stenosis?
To provide patients the absolute best treatment, Washington University neurosurgeons partner with The Barnes-Jewish Hospital Stroke and Cerebrovascular Center which is the first in Missouri—and one of the first in the United States — to be designated a Comprehensive Stroke Center by the Joint Commission and the American Heart Association/American Stroke Association. This certification is awarded to hospitals that achieve higher standards and meet specific criteria for resources, staff and training that are essential to treat the most complex stroke cases.
In the Center, a multidisciplinary team coordinates treatments for carotid stenosis. The team includes Washington University cerebrovascular surgeons, neurologists, and neuro-radiologists.
We have a policy of urgent treatment for all patients with symptomatic carotid artery stenosis (carotid stenting or carotid endarterectomy) within 24 hours of diagnosis.
For more information about the strict criteria to be designated a Comprehensive Stroke Center, see Barnes-Jewish & Washington University Stroke Center.
Carotid Stenosis Treatments
There are two primary options for the treatment of carotid stenosis:
This is a surgical procedure to remove fatty deposits (plaque) that are narrowing the arteries in your neck. It is the standard treatment for severe buildup of plaque in the carotid artery. During this procedure, the surgeon
- makes a small cut in the patient’s neck at the spot where the artery is blocked or narrowed
- opens up the narrowed artery and removes the plaque
- make the artery as smooth and clean as possible
- closes up the artery and the cut
Surgery usually lasts about 1-2 hours. Patients are generally able to return to work within a month, but should make healthy lifestyle changes to reduce the chance of further plaque deposits and to lower the risk of stroke.
Stenting is often recommended for people who are unable to undergo an endarterectomy (e.g. for people who can’t tolerate the side effects of anesthesia). A stent is a slender metal-mesh tube that is placed inside an artery to keep the artery open.
Carotid stenting is a treatment that offers an effective means of re-establishing blood flow through blocked carotid arteries and is part of a stroke prevention strategy. The goal of carotid stenting is the restoration of adequate blood flow (revascularization) through the affected part of the body by enlarging the blood vessel from within.