CONDITIONS · MARYLAND & VIRGINIA
Carotid Artery Evaluation & Treatment
Carotid artery narrowing can increase stroke risk, but evaluation and treatment are not the same for everyone. Learn when testing may be appropriate and how specialists compare medical care with procedural options.
What is carotid artery stenosis?
The carotid arteries run through the neck and carry blood toward the brain. Atherosclerotic plaque can narrow these arteries; this is called carotid artery stenosis or carotid artery disease. A clot or plaque fragment can interrupt blood flow to part of the brain and cause a transient ischemic attack (TIA) or stroke.
Stroke and TIA symptoms are emergencies
- Sudden weakness or numbness of the face, arm or leg, especially on one side.
- Sudden trouble speaking, understanding speech or seeing clearly.
- Sudden loss of balance, coordination or the ability to walk normally.
- Symptoms that disappear after a few minutes still require emergency assessment.
When might carotid evaluation be considered?
Evaluation may follow a stroke or TIA, an abnormal finding, known carotid disease or another specific clinical concern. Carotid ultrasound is not a routine screening test for every adult without symptoms. A clinician should consider your history, symptoms and the question the test is intended to answer.
How are the carotid arteries evaluated?
A clinician reviews neurologic symptoms, vascular risk factors and prior imaging and performs an examination. A carotid duplex ultrasound can estimate blood flow and the degree of narrowing. CT angiography, MR angiography or another study may be used when more detail is needed for diagnosis or treatment planning.
How is carotid artery disease treated?
Care may include medicines and management of blood pressure, cholesterol, diabetes and tobacco exposure, with follow-up imaging when appropriate. For selected patients, carotid endarterectomy or carotid artery stenting may be considered. Prior stroke or TIA, degree of narrowing, anatomy, age, overall health and procedural risk all influence the recommendation.
Prepare for an individualized discussion
Bring prior carotid images or reports, hospital records from any stroke or TIA evaluation and a current medication list. Ask what the result means, whether follow-up is needed, and how medical care, endarterectomy and stenting compare in your situation. Call 911 for new or recent stroke symptoms that have not been assessed, even if they have gone away; do not wait for a routine visit.
More about this concern
Your questions, answered.
Does every carotid narrowing need surgery or a stent?
No. Medical management and monitoring may be appropriate. A procedure is considered only when its expected stroke-prevention benefit outweighs its risks for the individual patient.
Do I need a carotid ultrasound because I have risk factors?
Not automatically. Routine screening of adults without stroke or TIA symptoms is not recommended for the general population. Ask your clinician whether a specific finding or medical history gives the test a clear purpose.
Does dizziness by itself mean that a carotid artery is blocked?
Dizziness has many possible causes and does not identify carotid disease by itself. Sudden focal symptoms such as one-sided weakness, speech trouble or vision loss require emergency assessment.
What is the difference between endarterectomy and carotid stenting?
Endarterectomy removes plaque through an operation on the neck. Stenting supports the narrowed artery from inside using a catheter-based procedure. The safer and more beneficial choice depends on the person and the artery anatomy.
Let’s talk about your next step.
Our team can help you choose an office in Maryland or Virginia and confirm where your evaluation or procedure will take place.
Patient education sources
General educational information, not a diagnosis or an individual treatment recommendation. Your clinician can explain which options are appropriate for you.