How Is Carotid Artery Disease Treated?

Treatments for carotid artery disease may include heart-healthy lifestyle changes, medicines, and medical procedures. The goals of treatment are to stop the disease from getting worse and to prevent a stroke. Your treatment will depend on your symptoms, how severe the disease is, and your age and overall health.

Heart-Healthy Lifestyle Changes

Your doctor may recommend heart-healthy lifestyle changes if you have carotid artery disease. Heart-healthy lifestyle changes include:

• Heart-healthy eating
• Aiming for a healthy weight
• Managing stress
• Physical activity
• Quitting smoking

Medicines

If you have a stroke caused by a blood clot, you may be given a clot-dissolving, or clot-busting, medication. This type of medication must be given within 4 hours of symptom onset. The sooner treatment occurs, the better your chances of recovery. If you think you’re having a stroke, call 9–1–1 right away for emergency care.

Medicines to prevent blood clots are the mainstay treatment for people who have carotid artery disease. They prevent platelets from clumping together and forming blood clots in your carotid arteries, which can lead to a stroke. Two common medications are:

• Aspirin
• Clopidogrel

Sometimes lifestyle changes alone aren’t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have:

• Diabetes
• Heart disease or have had a stroke
• High LDL cholesterol levels

Doctors may discuss beginning statin treatment with those who have an elevated risk for developing heart disease or having a stroke.

You may need other medications to treat diseases and conditions that damage the carotid arteries. Your doctor also may prescribe medications to:

• Lower your blood pressure.
• Lower your blood sugar level.
• Prevent blood clots from forming, which can lead to stroke.
• Prevent or reduce inflammation.

Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to. Your health care team will help find a treatment plan that’s right for you.

Medical Procedures

You may need a medical procedure if you have symptoms caused by the narrowing of the carotid artery. Doctors use one of two methods to open narrowed or blocked carotid arteries: carotid endarterectomy and carotid artery angioplasty and stenting.

Carotid Endarterectomy

Carotid endarterectomy is mainly for people whose carotid arteries are blocked 50 percent or more.

For the procedure, a surgeon will make a cut in your neck to reach the narrowed or blocked carotid artery. Next, he or she will make a cut in the blocked part of the artery and remove the artery’s inner lining that is blocking the blood flow.

Finally, your surgeon will close the artery with stitches and stop any bleeding. He or she will then close the cut in your neck.

Carotid Endarterectomy

The illustration shows the process of carotid endarterectomy. Figure A shows a carotid artery with plaque buildup. The inset image shows a cross-section of the narrowed carotid artery. Figure B shows how the carotid artery is cut and how the plaque is removed. Figure C shows the artery stitched up and normal blood flow restored. The inset image shows a cross-section of the artery with plaque removed and normal blood flow restored.

Carotid Artery Angioplasty and Stenting

Doctors use a procedure called angioplasty to widen the carotid arteries and restore blood flow to the brain.

A thin tube with a deflated balloon on the end is threaded through a blood vessel in your neck to the narrowed or blocked carotid artery. Once in place, the balloon is inflated to push the plaque outward against the wall of the artery.

A stent (a small mesh tube) is then put in the artery to support the inner artery wall. The stent also helps prevent the artery from becoming narrowed or blocked again.

Carotid Artery Stenting

The illustration shows the process of carotid artery stenting. Figure A shows an internal carotid artery that has plaque buildup and reduced blood flow. The inset image shows a cross-section of the narrowed carotid artery. Figure B shows a stent being placed in the carotid artery to support the inner artery wall and keep the artery open. Figure C shows normal blood flow restored in the stent-widened artery. The inset image shows a cross-section of the stent-widened artery.