There are 4 arteries that supply blood to the brain. The 2 carotid arteries on each side of the neck are the most important because they supply blood to the parts of the brain that are involved in thinking, movement, sensation and speech. The other 2 arteries that bring blood to the brain, called the vertebral arteries, supply the brainstem.
Narrowing of the carotid arteries can increase risk for stroke and death. In addition, if the narrowing is due to Peripheral Arterial Disease (PAD), patients are also at increased risk for heart attacks.
There are several causes for developing a narrowing in the carotid artery, but by far the most common cause is peripheral arterial disease (PAD).
If you have more than 15% narrowing in your carotid artery from PAD, you need to control risk factors through medical treatment and by not smoking at all.
If you have had a TIA (mini stroke) or stroke and you have a narrowing of greater than 50% in your carotid artery, you probably can significantly reduce you risk of stroke and death if you have the carotid narrowing fixed.
If the narrowing is less than 50%, you will reduce you risk of stroke and death more by medical management alone, rather than surgery.
The risks for both open surgery and stenting are bleeding, infection, stroke, heart attack and death. The risk of stroke and death are low. Open surgery also has a small risk (5%) of damaging the nerves around the carotid artery.
If these never are damaged, patients may have a hoarse voice, tongue weakness, a slight drooping of the face, or, in rare cases, difficulty swallowing. Proper nerve function usually returns in several days but can take as long as several weeks or months. If damaged,
If the carotid artery branch that supplies the brain (internal carotid artery) is 100% blocked, the artery will clot all the way up into the skull.
There is no surgery that can successfully re-open this artery once it is 100% blocked. The brain will get blood from the other 3 arteries, but you will be at increased risk for having a stroke and will need to control your risk factors.