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Home :: Stroke :: Stroke Treatment Options : Carotid Artery Disease
Carotid Artery Disease
Carotid arteries are two major arteries that supply blood to the brain and are located on either sides of the neck. Each of these arteries divides into two major branches, the external and the internal carotid arteries. The external carotid supplies blood to the face and scalp while the internal carotid artery supplies blood to the brain and hence is more precious.

Sometimes, due to carotid artery disease, plaque builds up on its inner surface and reduces the blood flow through it. This can pose a serious problem because clots can form on the plaque and block the blood flow to the brain or the disease itself can cause it to block. This can lead to an ischemic stroke, which can cause brain damage or death. If a small piece of the plaque or the clots from the plaque break away they can blocks another artery downstream. If this blocks a tiny artery in the brain, it may cause temporary neurological symptoms, called transient ischemic attacks (TIAs), sometimes called "mini-strokes."
Carotid Artery Disease
Treatment:
There are two methods of treating Carotid artery disease: one method involves having a stent inserted into the artery in the narrowed region, and the other includes surgical removal of the plaque, known as carotid endarterectomy.
Carotid Stenting
Carotid Stenting:
In this procedure the patient is taken to an angiography suite or catheterization lab. The procedure is done under local anesthesia. A small needle is inserted in the groin area to make a small hole in the artery. Through this hole a catheter (plastic tube) is passed along the inside of the artery to the neck close to the plaque. The physician then locates the plaques in the arteries by injecting a dye through the catheter and taking live x-rays, called fluoroscopy. This helps to guide them to the blockage. Once the blockage is located, a stent is taken through the same catheter and carefully deployed across the plaque to open the artery and avoid any clots from getting dislodged from this diseased area. Sometimes a filter device called embolic protection device is placed in the artery ahead of the plaque before deploying the stent to avoid clots or debris that may break away from the plaque during the procedure to migrate into the brain.
Carotid Stenting
If the plaque is stiff than after putting the stent a balloon is inflated between the stent to expand it further. The Stent remain permanently in the carotid artery and the balloon is removed.
Carotid Stenting

Carotid Endarterectomy
The surgery can be performed under local anesthesia with sedation, or general anesthesia. An incision is made on the side of the neck over the carotid artery. The artery is opened and the plaque removed.

Carotid Endarterectomy

Sometimes a plastic tube, called a shunt, is put into the artery above and below the blockage to carry blood to the brain during surgery. After the artery is cleaned out, the incision is closed. Usually a patch is sewn over the opened area to maintain an even diameter
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