Carotid Artery Disease

When blood supply to the brain becomes blocked, it can cause damage in the form of a stroke. A stroke is a medical emergency and most commonly presents as facial weakness, arm weakness and difficulty with speech. Symptoms that resolve within 24 hours are known as a mini stroke or Transient Ischaemic Attack (TIA).

The two most common causes of a blockage are:

• a ‘plaque’ in the main blood vessel carrying oxygen to the brain, the Carotid Artery
• a blood clot that has travelled from the heart

The Carotid Artery is the main blood supply to each side of the brain and is the most common location for plaque. There are also smaller arteries within the spine at the back of the neck called Vertebral arteries.

Arteries are made up of a number of layers, all which help move oxygen-rich blood to the major organs and tissues around the body. Damage can occur to these layers over time due to genetics and a number of lifestyle factors. This allows fatty deposits, cholesterol and calcium to build up in the wall of the arteries, known as atherosclerosis.

Over time, plaque can grow and narrow the arteries to the legs. The more severe this gets, the less oxygen gets to the feet and toes below.

There are a number of factors that put people at risk:

• Increasing age
• High blood pressure
• High cholesterol
• Smoking
• Family history of heart disease or stroke

There are many ways a stroke can present, the most common being:

• Facial weakness
• Arm or leg weakness
• Difficulties with speech
• Sudden loss of vision in one eye

Other signs of stroke may include:

• Sudden onset severe headache
• Difficulty swallowing
• Dizziness, trouble walking or falls

Once diagnosed, a treatment plan will be discussed with Dr Bullen. The decision on what option is best for your condition is based on review of your history, physical examination and the results of your investigations.

People with plaque in the blood vessels to their brain can be treated with medications, and may also require surgery. There are two main types:

• Carotid Endarterectomy is an open procedure to remove the plaque inside the carotid artery. This is done through the neck by diverting the blood supply and repairing the artery to prevent cholesterol debris from travelling to the brain.
• Carotid Stenting is a minimally invasive (keyhole) treatment which involves inserting a stent (metal scaffold) within the plaque to open the channel and increase blood flow to the affected area of the brain. This is usually performed using Angiograms (specialised X-ray with contrast dye) via a small incision in the groin.

The type of treatment offered will depend on your age, health issues and extent of disease. We aim to fix your problem safely and with the shortest possible recovery time.