The Brain and Spine Institute is made up of experts in the field of neuroscience in order to bring patients the best healthcare in East Tennessee for a full range of neurological diseases and disorders.
Carotid artery stenosis or carotid artery blockage is the narrowing of the main arteries in the neck that supply blood to the brain caused by plaque in a blood vessel (atherosclerosis). This disease increases your chances of having a stroke.
Stroke secondary to carotid stenosis is a group of brain disorders involving loss of brain function caused by obstruction of the carotid arteries. This is usually related to hardening of the arteries (atherosclerosis). This condition occurs when a major portion of one or both carotid arteries (the arteries in the neck that supply blood to the brain) is narrowed or blocked. Stroke secondary to carotid stenosis is most common in older people and, often, there is underlying atherosclerotic heart disease and/or diabetes mellitus.
There is a big wave of technology to screen patients for carotid artery blockage (stenosis). The initial test after listening to the arteries with a stethoscope held over the neck is ultrasound examination of the arteries. More refined tests include contrast angiography and magnetic resonance angiography.
Once a diagnosis of carotid artery stenosis has been made, the next step is to determine whether the blockage requires treatment and, if so, which procedure should be performed. Surgery and/or anti-clotting medicines are used to treat this condition.
The time-honored therapy for carotid artery stenosis has been carotid endartectomy; an open operation through a neck incision where the blockage is removed and the artery repaired. The new procedure on the block is carotid artery stenting where the artery is dilated with a balloon placed over a catheter and a stent left in place to keep the artery open.
There are hazards involved in both of these procedures; the most serious being a major stroke. The stent approach is reserved for high risk patients and for those who have had previous carotid surgery, irradiation of the neck or complicating medical diagnoses, which would make open surgery hazardous. Obviously, most patients would prefer an operation that does not leave a neck scar, but this might not be the best option for many patients.
The best individual to help you decide which procedure should be done is a highly skilled vascular surgeon who is well-trained to perform both carotid endartectomy and carotid stenting. UT Medical Center offers a team of vascular surgeons who have pioneered such surgeries.
The University Vascular Surgeons have East Tennessee’s only approved program to train fellows in endovascular surgery. They performed the first carotid artery stent in Knoxville eight years ago. They have conducted courses in endovascular techniques to vascular surgeons, interventional radiologists and cardiologists from across the eastern United States. They have won national and international honors and recognition in research for new methods to improve outcomes of endovascular therapy. The medical center has the only basic science vascular research laboratory in East Tennessee and the first dedicated endovascular surgical suite in Knoxville.
To schedule an appointment, call 865.305.6970