Originator: Mr Pathak Consultant Vascular Surgeon, Joy Lewis, Vascular Clinical Nurse SpecialistDate: September 2011

Version: 2Date for Review: September 2014

DGOH Ref No: DGOH/PIL/00491

Carotid Artery DiseaseVascular SurgeryPatient Information Leaflet

2 7

What are the carotid arteries?

The carotid arteries are theblood vessels that carryoxygen-rich blood to the head,brain and face. They arelocated on each side of theneck. You can easily feel themby placing your fingers gentlyeither side of your windpipe.

The carotid arteries supply essential oxygenated blood to the largefront part of the brain. This part of the brain controls thought,speech, personality as well as our sensory (our ability to feel) andmotor (our ability to move) functions.

What is carotid artery disease?

The brain survives on a continuous supply of oxygen and glucosecarried to it by blood.

Carotid artery disease is the narrowing or blockage of thesearteries (stenosis) due to plaque build-up (atherosclerosis). Theplaque can then crack, and develop an irregular surface, which iswhen it begins to cause problems.

Mr Jayatunga - Consultant Vascular SurgeonSecretary - Alison Slater Tel no - 01384 244243Mr Patel - Consultant Vascular Surgeon Secretary - Joanne Webb Tel no - 01384 244021Mrs Shiralkar - Consultant Vascular Surgeon Secretary - Faye Langford Tel no - 01384 244246Mr Pathak - Consultant Vascular Surgeon Secretary - Maxine Winmill Tel no - 01384 244245Mr Rehman - Consultant Vascular Surgeon Secretary - Lara Golding Tel no - 01384 244176Joy Lewis - Vascular Nurse SpecialistTel no - 01384 456111 Mark Black - Chief Vascular ScientistTel no - 01384 456111 Darren Rhodes - Vascular TechnologistTel no - 01384 456111

Further help and information

Web: www.circulationfoundation.org.uk

Access to benefits can be found on:-www.direct.gov.uk, www.dwp.gov.uk or your local Benefits office.

Russells Hall Hospital - Patient Advice and Liaison Service (PALS)Freephone 0800 073 0510.

Copyright EMIS circulation foundation.Reviewed: 20 Jul 2009 DocID: 4560 Version: 39

6 3

If a piece of plaque or a bloodclot breaks off from the wall ofthe carotid artery it can blockthe smaller arteries of the brain.

When blood flow to the brain isblocked, the result can be atransient ischemic attack (TIA),which is a temporarily affectsbrain function or a stroke,which is permanent loss ofbrain function.

Common symptoms of TIA include brief attacks of weakness,clumsiness, numbness or pins and needles of the face, arm or legon one side of the body. The eye can also be affected resulting inloss of vision in one eye. This is called Amaurosis Fugax. Carotidartery disease is one of the most common causes of stroke. Morethan half of the strokes occur because of carotid artery disease.

What causes carotid artery disease?

Although everyone is affected to some extent, there are severalinfluences determining how severe it is in individual people.Some are fixed, such as being male, having a family history ofstroke or angina, or getting older.

It is likely that if you have had a stroke, a TIA or amaurosis fugaxthat you will be advised to have the operation as soon as possibleto prevent a further stroke.

How can I help myself

You should consider doing what you can to reduce the risk of toyour general health. For example:

Eat a healthy diet which includes keeping a low salt intake.

If you are able, exercise regularly.

Lose weight if you are overweight.

Do not smoke.

Drink alcohol in moderation.

If you have high blood pressure, diabetes, or a highcholesterol level, they should be well controlled on treatment

You may be prescribed a statin drug to lower your cholesterollevel and low-dose aspirin to help prevent blood clots fromforming.

Vascular team contact details

If you require any further information regarding our services, or anyqueries about your management please contact Joy LewisVascular nurse specialist or the consultant managing yourcondition via the following telephone numbers.

Others can be modified such as smoking, high cholesterol, highblood pressure or diabetes. If you already have peripheral arterialdisease (PAD) or coronary heart disease you are at higher risk ofcarotid disease and stroke.

Furring of the arteries is a normal part of the ageing process;however it does need to be monitored throughout the body,especially around major arteries and the heart where it can causeheart attacks and angina.

How is the diagnosis made?

The diagnosis is usually made with an ultrasound scan of thearteries in the neck (duplex), or sometimes after a CT or MR scan.Diagnosis of this condition is important because it increases therisk of you having a stroke in the future.

Can medication help?

All patients with carotid artery disease can benefit from takingaspirin and a statin and from treatment of their individual riskfactors, particularly stopping smoking completely.

There are multiple benefits from giving up cigarette smoking,including reducing the excessive tendency for blood to clot,increasing the amount of oxygen in the blood and most importantlypreserving the cells lining the blood vessels which are verysensitive to the toxins in smoke.

The benefit of the aspirin is to reduce the stickiness of small bloodcells called platelets which adhere to the irregular surface of theplaque, but can then break off as a small clump. Where aspirin isnot appropriate, other anti-platelet drugs can be prescribed.

The benefit of a statin is partly in reducing the cholesterol, whichwas the initial reason for them being developed, but they alsoappear to reduce the tendency for atherosclerotic plaques to crackand so even patients with low cholesterol will benefit from takingthem.

Side effects to any of the medications suggested can be found onthe medicine information leaflet.

Will I need an operation?

In the carotid arteries, the problem is related to the possibility thatsmall pieces of solid material may break off the plaque and passwith the bloodstream into the brain causing a TIA or stroke.

There is good evidence that some patients, usually those withnarrowings greater than about 70% of the diameter of the artery,benefit from surgery; a carotid endarterectomy.

Your surgeon will advise you whether and when you need anoperation.

4 5