The Power Of Teamwork: Vascular Center

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WHAT IS CAROTID ARTERY DISEASE?
Carotid artery disease is a serious condition caused by a blockage in the major arteries in the neck providing blood to the brain that can lead to a stroke. The carotid arteries, which begin near the heart and extend up into the brain, can be narrowed or blocked by a build up of plaque on the inside of the artery. Plaque is a substance that builds up over time to cause not only the blockage, but also hardening of the arteries.

"Carotid artery disease is very common in this country. In fact, it's estimated that there are somewhere between 750,000 and a million strokes per year in this country with approximately 20%-30% of them caused by carotid artery disease."
-- Dr. Kenneth Rosenfield, Massachusetts General Hospital Vascular Center

Aside from patients who have carotid artery narrowing causing a stroke, there are more people walking around with carotid artery narrowing who may not even know it, and who may be at risk for having a stroke.

RISK FACTORS
• Family history of heart disease
• High blood pressure
• Smoking
• Diabetes
• High cholesterol
• Other blockages in arteries within the heart, kidneys and legs

EARLY WARNING SIGNS
Any of the following short-term symptoms that may come and go, called transient symptoms (or TIA, transient ischemic attacks), should be brought to your doctors' attention:

• Intermittent weakness in arms or legs on one side of your body
• Impaired or lost vision, in one or both eyes
• Inability to speak, difficulty swallowing, or drooping of one side of the face
• Inability to move one arm or leg

DIAGNOSIS
There are two simple non-invasive tests that can be performed in your doctor's office to determine if you have Carotid artery disease.
1. The doctor can listen to your neck with a stethoscope for a "whooshing" sound, called a bruit, which may indicate a narrowed artery.
2. If your doctor hears a bruit, a recommendation may be made to have an ultrasound to look at the carotid artery.

Additional tests can be performed to determine the degree of carotid artery narrowing. A magnetic resonance angiogram (MRA) or a CT scan (CTA) with an injection of dye into the arteries enables doctors to see if there is plaque in the arteries or not, and determine the best treatment option.

Massachusetts General Hospital is participating in new and innovative treatments for carotid artery disease, using the less invasive technique of angioplasty and stenting. Our Vascular medicine doctors have the most experience in New England with stenting of carotid arteries. Learn more about the active clinical trials available for carotid artery disease.

PREVENTION AND TREATMENT
Massachusetts General Hospital Vascular Center sets the standard when it comes to treating vascular disease, and offers state-of-the-art evaluation for all types of vascular disease.

If you think you might be at risk, for carotid artery disease there are some lifestyle changes you can make to minimize your risk.

• Watch your blood pressure, and make sure it is well controlled
• Exercise regularly
• Eat less fatty foods
• Monitor your cholesterol, know your numbers and cholesterol goals
• Stop smoking
• Control your diabetes

Early diagnosis and treatment could reduce the risk of having a stroke related to carotid artery disease. Medical therapy and follow-up ultrasound may be the right course of action for patients found to have less severe carotid artery disease.

For more serious cases of carotid artery disease (70-80% arterial blockage with symptoms, or more than 80% narrowing even without symptoms), invasive procedures may berecommended.

• Carotid endarterectomy – surgical procedure to open the artery and remove the plaque
• Carotid angioplasty/stenting – minimally invasive non-surgical procedure to open the narrowing and place a flexible mesh tube (stent) into the artery to keep the artery open.

The vascular center is one of only a few centers in New England where many patients have an opportunity to be treated with a stent. Learn more about how Massachusetts General Hospital Vascular Center works to ensure that patients receive the most comprehensive care.

To make an appointment or to refer a patient for care at the vascular center, please call the Vascular Center Access Line at 877-644-8346. A nurse-coordinator is available to take pertinent information and facilitate access to the most appropriate specialist.

Sources

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