Twenty to thirty percent of all strokes are caused by carotid artery disease (CAD), the most common form of cardiovascular disease in the United States. CAD occurs when the carotid arteries, which provide the main blood supply to the brain, become narrowed or blocked. Individuals with carotid artery disease are at significantly higher risk of stroke, the fifth leading cause of death in the U.S. The risk of stroke and death is twice as high for African Americans, which is why prevention through treatment of CAD is important.
Most often, carotid artery disease is not discovered in patients until after they have suffered a stroke or transient ischemic attack (TIA). Therefore, it is important for individuals to know the main risk factors associated with the disease, which includes genetics, history of smoking, high blood pressure, high cholesterol, and diabetes. Sometimes, CAD can be detected in a routine check-up through listening to the neck with a stethoscope. If a blockage is suspected, a cardiologist needs to determine where the blockage is and how severe it is, which can be done using an ultrasound. CT angiograms and MRA’s are also used to diagnose the blockage. Criteria for surgery include:
- If symptomatic (suffered a stroke or TIA) – a blockage of 60% or greater should be fixed.
- If no symptoms – a blockage of 80% or greater should be fixed.
Other than lifestyle modifications and certain medications, the main methods of treating severe carotid artery blockages are through procedures such as carotid endarterectomy or carotid angioplasty and stenting. Carotid angioplasty is a less invasive procedure with quick recovery times. Cone Health has an exceptional network of vascular surgeons, cardiologists and related healthcare providers dedicated to treating CAD, improving patients’ quality of life and helping prevent heart attack, stroke and amputation.
Dr. Charles Fields is a vascular surgeon with Vascular & Vein Specialists of Greensboro and a member of Cone Health Medical Group. He received his Bachelor of Science in chemistry from Wake Forest Baptist University and completed medical school at Medical College of Virginia. He completed his residency and his fellowship in general surgery at Virginia Commonwealth University, School of Medicine. Dr. Fields completed his vascular surgery fellowship at the Mayo Clinic School of Medicine in Rochester, Minnesota.