Carotid Artery Disease
Treatment

Mild to moderate blockages in the carotid artery are treated with medications called antiplatelet agents, such as aspirin, that block the formation of blood clots. In addition, treatment involves identifying and reducing risk factors, such as cigarette smoking and high blood pressure.

Ultrasound studies are repeated over time to monitor the blockage.

Surgery

If your carotid artery disease progresses, you may need surgery.

A number of large studies in the 1990s demonstrated that surgery — called carotid endarterectomy — was the best treatment for reducing the risk of stroke in patients with severe blockages in the carotid arteries. Research continues, however, on new, less invasive procedures, such as carotid artery stenting.

Carotid artery endarterectomy involves:

• Opening the artery
• Removing the plaque that is causing the narrowing
• Closing the artery, usually with a synthetic patch

During surgery, a temporary bypass is often used to allow blood to flow around the area of surgery as it travels to the brain.

Not all patients are candidates for surgery, particularly those patients who are in overall poor health or have other health issues.

Balloon Angioplasty and Stents

Other new non-surgical options to treat blockages in the carotid arteries include balloon angioplasty and stents. Both of these procedures use a catheter-guided balloon, inflated in the blocked area, to open up the carotid artery.

A metal stent may be inserted to help keep the artery expanded.

Currently, angioplasty and stents are recommended only for patients who aren't candidates for conventional surgery because the risk of stroke during the procedures and the long-term results are still being studied.

Reviewed by health care specialists at UCSF Medical Center.