Rhode Island Vascular Institute (RIVI)

Carotid Artery Disease: Stroke Prevention

Background
The carotid arteries are the dominant arteries in the neck that supply blood to the brain. Although often asymptomatic, plaques in the carotid arteries are one of the most frequent causes of strokes. There are approximately 250,000 strokes in the U.S. each year, and they are a source of tremendous disability and cost. Approximately 200,000 people each year in the U.S. undergo procedures to reverse blockages in the carotid arteries.

Diagnosis
The carotid arteries can be examined readily using a noninvasive imaging technique, duplex ultrasound, that is highly accurate. Because carotid artery blockages have been studied extensively, the risk of stroke can be determined accurately using this test. Medicare is close to approving this test without any symptoms or signs of the disease.

Treatment
Historically, carotid artery blockages that pose a risk for stroke have been treated with open surgery. This resulted in a long scar in the neck, with a 20% incidence of significant complications like bleeding or tongue paralysis. Recently, advances in catheter-based therapies have resulted in FDA approval of stents to treat carotid artery blockages. These can be done without any neck incision and usually people are discharged from the hospital the day following the procedure.

Research
The Rhode Island Vascular Institute is participating in the National Institutes of Health-sponsored CREST (Carotid Revascularization Endarterectomy vs Stent Study), and will be happy to discuss participation in this study with you if you qualify.