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Treatments

Determining Treatment

Your treatment will depend on:

  • The severity of your condition
  • Whether you are having symptoms
  • Your general health

Treatment Options

Treatments can range from lifestyle changes to medications to medical procedures, including surgery.

Lifestyle changes

Changing your lifestyle may keep your carotid artery disease from progressing. For some people, such changes are all that is needed in terms of treatment. These include:

  • Smoking cessation. Smoking can damage your arteries and raise your risk of stroke.
  • Regular exercise. Make sure to check with your doctor first about how much and what kinds of physical activity you should do. Generally, 30 minutes a day most days is recommended.
  • Weight loss. If you are overweight, losing weight can reduce your risk of stroke.
  • Healthy eating. Follow an eating plan aimed at lowering blood pressure and cholesterol. Such a diet should be low in saturated fats and sodium.

Medication

You may need medications to treat diseases and conditions that damage the carotid arteries.

  • These conditions include high blood pressure, high cholesterol and diabetes.
  • Some medications may be recommended specifically to prevent blood clots.
    • These medications may include anti-platelet medications ranging from simple aspirin to prescription drugs such as clopidogrel (Plavix) or dipyridamole (Aggrenox).
    • These may be prescribed alone or together to reduce your risk of stroke.
    • These drugs, including aspirin, work to thin the blood and prevent platelets from sticking together.
    • In some cases, the prescription drug warfarin (Coumadin) may be prescribed as well.

Open Carotid Endarectormy Surgery

You may need surgery if your carotid artery disease is severe or is progressing. Surgery is typically performed on symptomatic patients whose carotid arteries are blocked 50 percent or more, or on patients with greater than 80 percent blockage and no symptoms.

In this procedure, your vascular surgeon will make an incision in your neck to get to the blocked artery. General anesthesia is used. Once inside, your surgeon will remove the plaque that is blocking your artery. The procedure usually takes less than 2 hours and most people go home the next day. You should be able to return to normal activities within one to two weeks.

Endovascular Carotid Angioplasty and Stenting

Endovascular carotid angioplasty and stenting, a newer, minimally invasive procedure, is a good option for some patients. Your doctor will discuss the best treatment with you.

The procedure is performed while you are awake, but under a local anesthetic. During the procedure, a balloon-tipped catheter or thin tube is threaded to your blocked carotid artery through a small puncture site over a groin artery. Your vascular surgeon will use X-ray pictures, called an angiogram, to guide movement of the catheter to the area of the obstruction. The balloon-tipped catheter is then inflated, flattening out the plaque against your artery walls. Next, your doctor will place a tiny metal-mesh tube called a stent in the artery to keep it open. The stent stays there permanently. It acts as a scaffold to support the artery walls and keep the artery open.

With this procedure, you will stay in the hospital for one day. You should be able to return to normal activities within one to two weeks.

Contact Information

Cardiovascular Medicine
Division of the CardioVascular Institute
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
617-667-8800

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