Carotid Artery Disease
Carotid Stenosis and Carotid Occlusion
Call for an AppointmentOur specialized vascular neurologists, vascular surgeons, and neurosurgeons identify and treat carotid artery disease at every stage. Because carotid disease is a leading risk factor for stroke, our goal is to help you lower your risk for stroke and remain healthy. We offer a variety of treatment options, including lifestyle modifications, medications, and advanced surgical techniques.
About Carotid Artery Disease
Carotid artery disease is the buildup of fatty deposits (called plaque) on the inner walls of your carotid arteries, two of the main blood vessels that carry blood and oxygen to your brain. The plaque can cause your carotid arteries to become narrow, known as carotid artery stenosis, or become completely blocked, known as carotid artery occlusion. Small bits of unstable plaque can also break off and travel to the brain, causing stroke.
Carotid disease develops over time, and many people don’t know they have it. It might be discovered during testing for a separate medical condition, and you may not have any clinical symptoms at all. In that case, it’s important to monitor risk factors -- including family history of carotid artery disease, high cholesterol, high blood pressure, obesity, diabetes, and tobacco use -- and to seek treatment immediately if you experience sudden symptoms like numbness or weakness, trouble speaking or understanding, vision loss, dizziness or balance problems, or severe unexplained headache.
In other cases, carotid disease may go undiagnosed until it causes a stroke or TIA (transient ischemic attack, or mini-stroke); both require emergency care.
Duke Health offers locations throughout the Triangle. Find one near you.
Tests for Carotid Arteries
In addition to discussing your medical history and performing a thorough examination, we use a variety of advanced screening technologies to capture highly detailed images of your carotid arteries to determine if they are narrowed or blocked by plaque buildup.
Ultrasound
A noninvasive test that uses sound waves to measure the speed of blood flow in carotid arteries and creates high-quality images showing how well blood is flowing through the carotid arteries. This test takes 20 to 40 minutes and is painless.
CT Angiography (CTA)
After a contrast dye is injected into your body, a CT scan (which delivers a small amount of radiation) produces highly detailed images of your blood vessels, bones, and surrounding soft tissues. This creates a "map" of your arteries and indicates areas that are narrowed, blocked, or damaged. This test usually lasts from 30 to 60 minutes. Apart from some discomfort during the injection, this test is virtually painless.
Magnetic Resonance Angiography (MRA)
After contrast dye is injected into your body, powerful magnets and a computer create detailed images that better define the soft tissue of your brain and blood vessels. This test usually lasts from 30-60 minutes. Apart from some discomfort during the injection, this test is virtually painless.
Catheter-Based Arteriogram
An arteriogram helps better define your blood vessel anatomy and is sometimes used to further evaluate an area of concern found on CTA or MRA images. This is performed in a sterile radiology suite and requires a small catheter (a narrow, flexible tube) to be placed in an artery in your groin or wrist. Using X-ray guidance, the catheter is advanced to the neck vessels. Then dye is injected directly into the artery of interest, allowing a short video of your circulation to be recorded.
When it comes to your care, you want the very best. Duke University Hospital's nationally ranked neurology and neurosurgery program was named best in North Carolina by U.S. News & World Report for 2019–2020.
Why Choose Duke
TCAR Center of Excellence
Duke was designated a Center of Excellence by TCAR developer Silk Road Medical. This classification recognizes that we use the TCAR procedure for the right patients, we have a well-trained and credentialed team, and we are committed to delivering high-quality care.
Coordinated Stroke Prevention and Care
Because carotid artery disease is a leading risk factor for stroke, you have access to our nationally recognized team of vascular neurologists, vascular surgeons, and neurosurgeons who work together to prevent and treat stroke. Our surgeons perform hundreds of procedures to open blocked carotid arteries each year and are nationally recognized surgical experts.
Clinical Research Opportunities
Duke may have opportunities for you to participate in clinical trials studying new and better ways to treat carotid disease or associated risk factors. This could give you access to these novel treatments before they’re widely available. As invited participants in a National Institutes of Health study of minimally invasive and surgical approaches to carotid artery disease, our surgical team underwent additional rigorous training and credentialing.