How is Carotid Artery Stenosis Diagnosed?
Your doctor may perform a physical examination using a stethoscope to listen to your carotid arteries. A “whooshing” sound may be heard when a carotid artery is very narrow, indicating the need for other tests.
At NewYork-Presbyterian, we use the following tests to diagnose carotid artery stenosis:
- Carotid ultrasound using a duplex scan, a noninvasive way to assess blood flow in the carotid arteries using sound waves and to periodically monitor a patient with carotid stenosis to see if it is getting worse.
- Computed tomography (CT) angiography with contrast dye to see the blood vessels of the head and neck.
- Magnetic resonance angiography (MRA), a special type of MRI that shows details of the blood vessels.
- Cerebral angiography, a procedure to acquire more information about the carotid arteries if needed.
How is Carotid Artery Stenosis Treated?
If you are diagnosed with carotid artery stenosis, your doctor will create a plan of care tailored to your needs.
Your treatment for carotid artery stenosis may include nonsurgical therapies or a surgical approach. Your team will discuss each approach’s risks and benefits to determine the best course of action for your care. If you need a procedure, you may only need to stay in the hospital overnight.
You may be advised to exercise more, lose weight, and eat a healthier diet. Changes such as these are good for your overall health and the health of your arteries.
If your carotid artery blockage is small, we may give you medications to reduce blood clotting, lower the levels of cholesterol and fats in your blood, and reduce your blood pressure. For some people, medication is the only treatment needed.
This surgical treatment of carotid artery stenosis involves removing the plaque inside a narrowed carotid artery to reduce the risk of a future stroke.
Carotid angioplasty and stenting
During a carotid angioplasty and stenting, the doctor advances a small balloon through a flexible tube (catheter) placed into an artery in your groin and threaded to the carotid artery. Once at the site of the blockage, the balloon is inflated to open the carotid artery, and a stent (small mesh tube) is put in place. The stent stays in your carotid artery to provide a channel through which blood can flow more freely.
There is a small risk of pieces of plaque breaking off and causing a stroke, so before the stent is put in place, the doctor inserts a small filtering device further down into the blood vessel to trap any plaque pieces and prevent a stroke from occurring.
Carotid bypass revascularization
A neurosurgeon reroutes the blood supply around the blockage to bypass the obstruction in your carotid artery. You may have this procedure if other carotid stenosis treatments are not effective options for you.
Investigators at Weill Cornell Medicine and Columbia University participate in clinical trials to improve carotid stenosis care. You may have the opportunity to participate in a clinical trial of a promising new treatment.
A procedure to treat carotid artery stenosis is generally recommended for people with a narrowing of 70% or more.
Carotid stenosis is treated by neurologists, neurosurgeons, and vascular surgeons.
Carotid stenosis becomes symptomatic when a TIA or stroke has occurred. Before that point, there are no symptoms and you may not even know you have it.
Trust NewYork-Presbyterian for Carotid Artery Stenosis Treatment
At NewYork-Presbyterian, we use the latest technologies to diagnose and treat carotid artery stenosis, including medical therapies and minimally invasive surgical procedures. Our Neurological Intensive Care Units (Neuro-ICUs) provide monitoring around the clock and specialized treatment for the most critically ill patients and are among the few in the world with dedicated scanners within each unit, enabling us to perform immediate imaging of the brain.
Our teams understand the symptoms and causes of carotid artery stenosis and stroke and match you with the most appropriate therapies. Come to NewYork-Presbyterian for the most advanced neurologic care in New York. Make an appointment for a consultation.