Carotid Artery Stenosis

When a lot of plaque builds up in your carotid arteries, you could be at risk of a stroke.

The carotid arteries in your neck supply essential blood and oxygen to your brain. Plaque buildup from fat and cholesterol can block these arteries, reducing blood flow and putting you at risk of having a stroke. This narrowing of the carotid artery is called carotid artery stenosis (or carotid artery disease).

If you’ve been diagnosed with carotid artery stenosis, it’s natural to be concerned. But the experts at Cleveland Clinic will put you at ease. We’re highly experienced in treating carotid artery stenosis. Our skilled, compassionate team is with you at every step, answering your questions and providing excellent care and support.

Why Choose Cleveland Clinic for Carotid Artery Stenosis Care?

National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Specialized knowledge:

We treat thousands of people (most with complex medical histories) each year for vascular conditions, including carotid artery stenosis. Many people travel from across the U.S. and the globe to see our world-renowned experts. Meet our team.

Recognized expertise:

We’ve received numerous awards and recognition for our vascular care. The Joint Commission has also recognized Cleveland Clinic for its excellence in stroke care. Fewer than 100 hospitals in the U.S. have received this recognition. You can trust our specialists to effectively manage your risk factors for stroke, including carotid artery stenosis.

Skilled collaborative providers:

At Cleveland Clinic, you’ll receive the highest level of care from a team of highly skilled specialists who are leaders in their fields. Your team may include specialists from different areas all working together to give you the most comprehensive care.

Personalized care:

Cleveland Clinic’s advanced imaging and ultrasound let us precisely diagnose carotid artery stenosis and offer personalized treatment options.

Diagnosing Carotid Artery Stenosis at Cleveland Clinic

At your first appointment, we’ll ask about your symptoms and health history. We’ll also review any images you’ve already had taken.

If you’ve had symptoms of a stroke or transient ischemic attack (TIA) — sometimes called a mini-stroke — it may signal carotid artery blockage. TIA symptoms can last several minutes to 24 hours and include:

Vision changes.
Dizziness.
Loss of coordination and balance.
Trouble speaking.
Facial drooping.
Paralysis or inability to move parts of your body, like your arm or leg.

If we think you’ve had a stroke or TIA, we may order a CT scan (computed tomography scan) and MRI (magnetic resonance imaging) to look closely at your carotid arteries and brain.

If you haven’t had any stroke or TIA symptoms, we’ll do a thorough physical exam and order an ultrasound to see how well blood is flowing through your carotid arteries.

Meet Our Carotid Artery Stenosis Team

At Cleveland Clinic, your carotid artery stenosis care team may include experts from several different specialties — all working together to give you the most comprehensive diagnosis and treatment. Your team may include:

Cardiologists.
Neurologists.
Neuroradiologists (specialists who use imaging tests to diagnose and treat conditions of the head, neck, spine and brain).
Neurosurgeons.
Vascular medicine specialists.
Vascular surgeons.

Providers Who Treat Carotid Artery Stenosis

Locations

Our healthcare providers see patients at convenient locations throughout Northeast Ohio, Florida and London.

Treating Carotid Artery Stenosis at Cleveland Clinic

If left untreated, carotid artery disease can lead to stroke. Your treatment will depend on your symptoms and the amount of carotid artery blockage you have. We may be able to treat you without repair. But if you have severe blockage, repair might be the best option.

Treatment without surgery

If you don’t have any symptoms and only minimal blockage, we may recommend medication and lifestyle changes. We’ll partner with you and your primary care provider to help you:

Lower cholesterol and blood pressure.
Eat a balanced diet.
Increase physical activity.
Quit tobacco use.
Manage diabetes.

Surgery

If your carotid artery is severely blocked and you have symptoms, your provider may recommend repair. Procedures include minimally invasive carotid angioplasty and stenting or carotid endarterectomy, a traditional open surgery.

Our experienced surgeons will talk with you about your medical history, go over insurance coverage and review imaging to recommend the surgery that’s right for you. Options include:

Transfemoral or transradial carotid angioplasty and stenting (CAS): For this minimally invasive procedure, we’ll give you a local anesthetic to numb your groin or wrist area, so you won’t feel any pain. Then your provider will make a small puncture in your groin or wrist and guide a tube to the blocked artery. Through the tube, your provider will use a device to protect your brain temporarily during the procedure. This is done with a distal filter (similar to a fishing net) or a flow reversal device. Your provider will then inflate a balloon in the blocked area to stretch open the blockage and place a stent to repair the carotid artery. Our team is highly trained and experienced in carotid angioplasty and stenting.
Transcarotid artery revascularization (TCAR): This is a mix between the minimally invasive procedure and open surgery. While you’re under local or general anesthesia, your surgeon will make a small incision (cut) at the base of your neck on the side of the blockage. Then, they’ll guide a small tube into the artery below the blockage and connect it to another small tube in the vein in your groin. The artery is clamped, and flow is reversed away from your brain to protect it. Then, your provider will inflate a balloon in the blocked area to stretch open the blockage and place a stent to repair your carotid artery. The tube is then removed.
Carotid endarterectomy (CEA): This is a traditional open surgery. While you’re under either local or general anesthesia, your surgeon will make an incision in your neck where the blockage is. We’ll get rid of the plaque and repair the carotid artery.

Our team is highly trained and experienced in CAS, TCAR and CEA. We do over 400 of these procedures each year — giving us extensive experience. Our outcomes exceed national benchmarks.

Follow-up care

We don’t forget about you after treatment. We’ll provide ongoing care that lessens your risk for stroke. At your follow-up appointments, your provider will:

Reevaluate your risk factors for stroke.
Review your medications.
Order an ultrasound of your carotid arteries.
Adjust your treatment plan, as necessary.

Taking the Next Step

Blocked carotid arteries may lead to serious complications, including stroke, if left untreated. At Cleveland Clinic, our specialists are world renowned for diagnosing and treating carotid artery stenosis and are recognized for our excellent results. You’ll get comprehensive and compassionate care and support from a team of highly experienced specialists. Whether you need surgery or just help managing the condition with a healthy lifestyle, we’re here for you.