Carotid Artery Disease and Stroke Prevention

• Our Doctors & Providers
• Patient Resources

• Vascular Surgery
• Medical Center Campus
• Main Pavilion, Level 5
• 111 Colchester Avenue
  Burlington, VT, 05401
• Phone: 802-847-4548
• 1-877-817-5030
• Monday-Friday, 8 AM-5 PM
• Directions

Carotid artery disease -- also known as carotid occlusive disease or carotid stenosis -- occurs when the major arteries in the neck become narrowed or blocked due to fatty build-up or plaques. The carotid arteries are a pair of arteries that carry blood to the brain and head. The build-up of plaques, a process known as atherosclerosis, is a serious condition that increases your risk of stroke. Risk factors for carotid artery disease include:

• Cigarette smoking
• Aging: risk for the condition increases as you age
• High blood pressure
• High cholesterol
• Diabetes
• A family history of atherosclerosis or stroke

Carotid Artery Disease Treatment at Fletcher Allen

At Fletcher Allen, our highly skilled vascular surgeons provide expert stroke prevention care for patients with carotid artery disease.  We are committed to providing the best possible care and service for patients. We strive to provide the services you need in one visit -- minimizing the inconvenience of traveling for several appointments.

Our modern, state-of-the-art facility includes a nationally accredited minimally invasive vascular diagnostic laboratory, where imaging tests are done. Patients are often able to visit with a surgeon and have an imaging study on the same day.

Our surgeons use the latest technology and minimally invasive procedures to treat carotid artery disease. In addition, we are committed to personalized, patient-centered care.  Every patient who comes through our doors is seen and assessed by a vascular surgeon, who is involved throughout their care.

Because Fletcher Allen is a university hospital and health system in partnership with the University of Vermont, you can be assured that your care is informed by the latest scientific innovations and ground-breaking research. Your treatment is backed by a strong commitment to high-quality care and ongoing quality improvement. Fletcher Allen is also dedicated to patient education, making sure you have all the information you need to make informed choices about your care.

Fletcher Allen Received the Silver Plus Performance Achievement Award Hospital from the American Heart Association/American Stroke Association

The care our patients receive at Fletcher Allen is our number one priority. That’s why we’re proud to be among the hospitals recognized by the American Heart Association / American Stroke Association’s Get With The Guidelines® for our excellence in improving quality of patient care and outcomes.

Diagnosis: Carotid Artery Disease

Carotid artery disease in the early stages may not produce any symptoms. The first signal you have the disease may be a mini-stroke known as a transient ischemic attack or TIA. The warning signs for TIA include:

• Sudden numbness, weakness or paralysis on one side of the body
• Slurred speech
• Losing vision in one eye

If you experience any of these warning signs, even if only for a few minutes, you should seek medical attention immediately. If the symptoms last only for a short while, it is still important to talk to your doctor. A TIA is a warning sign that you are at risk of a full-blown stroke, which is permanent damage to your brain.

Diagnosing carotid artery disease at Fletcher Allen

Fletcher Allen’s vascular technologists are specially trained in the latest techniques to diagnose carotid artery disease. Diagnostic tests are performed in our non-invasive diagnostic laboratory located within the Vascular Surgery offices. The process of diagnosis may involve the following:

• Physical exam -- Your physician will conduct a full medical history and physical exam. He or she will listen for sounds of turbulent blood flow in your carotid arteries.

• Carotid duplex ultrasound -- With this test, a vascular technician holds a small ultrasound probe to your neck. High-frequency sound waves emitted by the probe bounce off the blood cells and vessels. The sound waves create an image of blood flow and blood vessel structures.

Non-invasive vascular laboratory

Diagnosing vascular problems typically begins in our nationally accredited non-invasive diagnostic laboratory, conveniently located in the Vascular Surgery clinic at Fletcher Allen’s Ambulatory Care Center. Patients are often able to see a doctor and have a non-invasive test during a single visit.

The lab is staffed by registered vascular technologists -- highly skilled specialists with advanced training in non-invasive vascular imaging and testing. By focusing solely on vascular problems, these technologists bring an in-depth knowledge to the diagnosis of vascular patients.

The lab offers imaging and testing for the full range of vascular problems affecting all areas of the body. It provides two main types of testing – physiological studies and ultrasound imaging. Both are non-invasive tests that are usually painless and relatively quick.  They enable your physician to decide whether additional, more invasive tests are needed. These studies also can identify problems such as arterial atherosclerosis or vein disease.

• Physiological studies -- Studies that measure the amount of blood traveling through the vessels with and without exercise. They help determine if blockages exist.

• Ultrasound imaging -- An imaging study that uses sound waves to produce a video image of your blood vessels. Ultrasounds are used to check for a potential aneurysm, as well as blocked blood vessels in the neck, abdomen or extremities. In some cases, it may be the only test necessary to determine the need for an operation or stenting procedure.

Treatment: Carotid Artery Disease

The goal in treating carotid artery disease is to prevent stroke. The type of treatment that is right for you will depend on the severity of your condition, your general health and the presence or lack of symptoms.

At Fletcher Allen, our specially trained vascular surgeons offer expert care in a personalized manner, working closely with you and your family. We offer the latest surgical and minimally invasive treatments for carotid artery disease, as well as medical management and help with lifestyle modifications.

We are committed to patient education through all stages of your treatment. We want to make sure you and your family have all the information you need to make the best decisions about your care.

Non-Surgical Treatments

• Lifestyle Changes -- Atheroscelosis, an underlying cause of carotid artery disease, often results from unhealthy habits and lifestyles. At Fletcher Allen, we are dedicated to patient education and helping you change your habits and adopt a healthy lifestyle.

• Improving diet and exercise -- Changes such as smoking cessation, exercise and weight loss can help reduce stress on your arteries and slow the process of atherosclerosis. We will help connect you with the resources you need to modify your lifestyle.

Medications

Medication may be recommended to help control carotid artery disease, and the underlying causes of the disease. At Fletcher Allen, we offer the full range of medical therapies and the latest pharmaceutical products available to treat your problem.

Your physician may prescribe blood-thinning medication or medicines to control your blood pressure or lower cholesterol. Other medications may be prescribed for patients with chronic conditions such as diabetes to help keep those conditions under control.

Surgery

If your carotid artery disease is severe, or if you’ve already experienced a TIA or stroke, surgery may be necessary. Our highly trained vascular surgeons perform the latest surgical techniques to treat carotid artery disease. Patients can be assured of working with experienced and knowledgeable surgeons, with access to the latest, cutting-edge technology. There are two main types of procedures for carotid artery disease. These include: 

• Carotid endarterectomy -- This is the most common surgical procedure for carotid artery disease, with low risk for otherwise healthy patients. Your surgeon will make an incision in the neck, open the affected artery and remove the plaque. The artery is then closed with sutures.  Once the plaque is removed, the artery is once again smooth and open. The procedure usually requires a one night hospital stay. 

• Carotid angioplasty and stenting -- This is a newly developed minimally invasive procedure for treating carotid artery disease. It may be recommended for patients experiencing symptoms who are considered at high risk for surgical endarterectomy. Your surgeon and care team will help determine whether this procedure is right for you. Stenting typically is only indicated if you are experiencing symptoms.With this procedure, a catheter with a special balloon on the end is guided into an artery in the groin. The catheter is guided to the blocked area in the neck. Once in place, the balloon is inflated and deflated several times to widen the damaged artery. Once the artery is opened, the surgeon places a stent -- a tiny wire mesh tube -- in the artery to keep it open and allow blood to flow more freely. Similar to endarterectomy, angioplasty and stenting usually require an overnight hospital stay.