Stroke prevention for vascular issues
Carotid artery disease is a serious medical condition that can cause a TIA or stroke and loss of life. Strokes can occur when plaque decreases blood flow to your brain because of the narrowing of an artery or by breaking loose and blocking an artery in your brain itself.
Fortunately, the specialists at Desert Vein & Vascular Institute are the leading experts in the Coachella Valley area for vein and vascular issues. Unlike most other vascular surgical groups, we are uniquely trained and experienced to offer all forms of diagnosis and therapy.
- Numbness on one side of your body
- Weakness, paralysis or loss of coordination on one side of your body
- Drooping on one side of your face or mouth
- Blindness or loss of part of the vision in one eye that typically is described as like a shade being drawn over an eye
Loss of speech or garbled speech
- The inability to write or understand writing
- Episodes of memory loss
- Loss of consciousness
The most common cause of stroke or Transient Ischemic Attack (TIA) is a blockage in one of your two internal carotid arteries, one on each side of your neck, which are the main arteries to your brain. Atherosclerotic plaque commonly develops in these arteries at the point where they divide into the artery to your brain (the internal carotid artery) and the artery to your face (the external carotid artery).
Your doctor may hear a noise in your neck called a bruit. A TIA or stroke is also often evidence. However, most often, the plaque is asymptomatic when it is detected by a noninvasive test called a Doppler Duplex Ultrasound scan that shows you blood vessels and the blood flowing through them. Patients who may benefit from one of these tests are those at risk for atherosclerosis may include:
- Elderly patients
- Those with known atherosclerosis elsewhere
- People with high cholesterol
- Patients with high blood pressure (hypertension)
- Those with a strong family history of stroke
Because blood vessels don’t show up on regular X-rays, an arteriogram may be necessary. Your DVVI doctor will insert a needle into an artery and inject a special dye to allow him to see detailed pictures of the inside of your arteries. A needle is usually inserted via your groin or femoral artery. A sensation of heat often accompanies the dye injection; however, local anesthesia and sedation is used to reduce pain. The procedure usually takes about 30 minutes. After it has been completed, the patient is required to lie flat for about four hours to prevent bleeding. The procedure is typically performed in an X-ray facility usually in a hospital. Unfortunately, arteriograms of the carotid arteries can cause stroke in as many as 1% of patients.
In some instances, a Magnetic Resonance Angiogram or MRA can replace the need for arteriograms. MRAs are performed using high energy magnets and result in pictures of the blood vessels and brain very similar to those obtained by arteriograms and CAT scans. They’re completely safe and painless but can’t be used in patients who have steel implants such as pacemakers. Some patients also become claustrophobic in the scanners. We have pioneered doing surgery without arteriograms to avoid this risk in most patients.
The surgical procedure to remove plaque is called a carotid endarterectomy. Although usually quite safe, some patients will suffer a stroke, nerve damage, or heart attack from this procedure. Accordingly, the benefits of this procedure will depend greatly on the skill of your surgeon. It’s imperative that you ask your surgeon about his or her experience.
The operation can be performed under general or local anesthesia. It takes about 60 minutes. The plaque is cut out of the artery and the artery is repaired. Most patients are sent to a regular ward following surgery and are discharged the next morning. There is very little discomfort. Normal activity can be resumed, but heavy exercise and driving is limited for one week. Thereafter, full return to normal activity is encouraged, including activities such as golf. Most patients will continue taking aspirin after the procedure. Follow-up duplex scans will be performed on a six-month basis to assess for the small chance of recurrent plaque or scar tissue that can also re-narrow the artery. This occurs significantly in about 4% of patients.
Call us now to learn more or to schedule a consultation: (760) 568-3461