Carotid Artery Stenosis (Stroke Risk)

The carotid arteries are responsible for providing blood flow to the brain. When plaque develops in the carotid arteries, blood flow to the brain can become restricted. This is known as carotid artery stenosis. If the carotid artery blocks completely, or if part of the plaque dislodges and travels to the brain, the individual can suffer a stroke. This can lead to paralysis, loss of ability to speak, blindness, loss of independence and even death. Stroke is currently a leading cause of disability and the third leading cause of death in the United States.

Certain known risk factors exist for the development of carotid artery stenosis. These include smoking, diabetes, high blood pressure, high cholesterol, family history of cardiac or vascular disease and advanced age. However, you do not necessarily need to have one of these risk factors to develop carotid artery stenosis.

Individuals with carotid artery stenosis may have symptoms or warning signs. These warning signs are called ministrokes or TIAs (transient ischemic attacks.) Ministrokes are temporary neurological deficits that usually last for just a few minutes, but can last for up to 24 hours. (When lasting longer than 24 hours, they are no longer considered a ministroke.) They may cause weakness or loss of coordination of one side of the body, sudden loss of vision in one eye (called amaurosis fugax,) the loss of ability to speak, or other neurological deficits. In some cases, no warning signs will be present and carotid artery stenosis will be completely silent until discovered on a physical examination, or until the individual suffers a stroke.

The diagnosis of carotid artery stenosis may be suspected if you experience one of the warning signs described above. In addition, your physician may hear a sound when he or she listens to your carotid artery with a stethoscope. If carotid artery stenosis is suspected, a doppler ultrasound test, called a duplex scan, can confirm the diagnosis. This is a noninvasive, painless test that can be performed in the office

The treatment of carotid artery stenosis depends upon its severity. If the blockage is mild and not causing symptoms, intervention may not be required. Your doctor may chose to give you medication and repeat the duplex ultrasound at some point in the future to be sure that the blockage has not become more severe. If you have experienced a warning sign and the blockage is more severe, intervention might be required in order to prevent a major stroke. In some patients, a surgical procedure called carotid endarterectomy is performed in order to clean out the plaque that is blocking the carotid artery. In other patients, the artery can sometimes be treated with a carotid stent, without the need for surgery. In all cases, modifying risk factors such as treating high cholesterol and, high blood pressure and stopping cigarette smoking is important. Our vascular surgeons are experienced in all of these various treatment options. They will thoroughly evaluate you and discuss these treatments with. They can then decide what is most appropriate for your particular situation.

Peripheral Arterial Disease (PAD)

The term peripheral arterial disease (PAD) is typically used to describe narrowing of the arteries of the legs. Plaque can build up in these arteries, which in turn limits the amount of blood and oxygen that reaches the muscle and other tissues of the legs. This can cause pain in the legs when walking, called intermittent claudication. In more severe cases, if left untreated, PAD can cause severe pain at rest, wounds, gangrene, and result in amputation. In addition, blocked arteries typically may occur in different areas of the body at the same time. Therefore, the presence of PAD can be an indicator of an individual’s increased risk for stroke, heart attack, or other vascular problems. Similar risk factors exist for the development of PAD as with carotid artery stenosis. These include smoking, diabetes, high blood pressure, high cholesterol, family history of cardiac or vascular disease and advanced age. However, an individual with PAD may not have any of these risk factors.

The diagnosis of PAD is usually first suspected by a patient’s history and physical examination. Noninvasive tests, such as doppler ultrasound and blood pressure measurements in the legs are typically used to help confirm the diagnosis. After the diagnosis is confirmed, more detailed testing such as angiography may be used, depending upon the severity of symptoms. The treatment of PAD depends on the severity of symptoms. In many cases, surgery is not required. Often, quitting smoking, dietary modification, medication and exercise are used to help relieve symptoms and prevent mild cases from becoming more severe. In other cases, minimally invasive procedures such as balloon angioplasty, and stents, or atherectomy can be used to treat PAD. At times, surgical procedures such as bypass are necessary to treat the most severe cases of PAD. Since our vascular surgeons perform all of these treatments, they will be able to tailor the most appropriate treatment plan to your particular problem unique situation.

Abdominal Aortic Aneurysm (AAA)

The aorta is the largest artery in the human body. It originates in the heart and travels through the chest and into the abdomen. It gives off branches that are responsible for supplying blood to the entire body. An abdominal aortic aneurysm (AAA) occurs when the walls of the aorta in the back of the abdomen become weakened. This causes the aorta to bulge like a balloon. If untreated, this bulge may become large and the walls become progressively weak and thin. This can ultimately cause the aneurysm to burst or rupture, which will lead to severe internal bleeding and often death. It is estimated that approximately 15,000 Americans die each year from a ruptured abdominal aortic aneurysm.

Certain risk factors are known to contribute to the development of AAA. Cigarette smoking, high blood pressure, and family history of AAA may increase one’s risk of developing AAA. In addition, individuals over 60 years old, those with known vascular disease (atherosclerosis,) or chronic lung disease (COPD) are at higher risk. Men are more commonly affected than women, although women do develop AAA.

Most individuals with AAA have no symptoms. The AAA is most commonly detected on a diagnostic test performed for an unrelated reason. However, some individuals may notice a pulsating sensation in their abdomen. Others may experience symptoms of an aneurysm enlarging or beginning to rupture. These symptoms usually include a sudden severe pain in the back, flank or abdomen. Occasionally, and individual with AAA may notice discoloration or pain in the feet related to blood clots dislodging from the AAA and traveling to the small arteries in the feet or toes.

The diagnosis of AAA can sometimes be made on a physical examination, however, due to its location in the back of the abdomen, the aorta is often difficult for your doctor to feel. Therefore, noninvasive ultrasound and CT scan testing is are often used to make the diagnosis. The treatment of AAA depends on its size and whether or not it is causing symptoms. When an AAA reaches a certain size, or is noted to be growing rapidly, it must be considered for repair. Abdominal aortic aneurysm can be repaired with an open surgical operation, or by placement of a less invasive stent graft, depending on the particular situation. The surgeons of Jersey Shore Center for Vascular Health perform both of these types of AAA repair.

They were the first physicians in this region to perform an aortic stent graft procedure, back in 2000. They will evaluate your particular situation, discuss the various treatment options, and recommend the most appropriate treatment for your case.

Treatment Descriptions coming soon