Stroke Prevention Program
Carotid Artery Disease & Stroke Prevention
Carotid artery disease is a narrowing of the major arteries in the neck that supply blood to the brain — and it is one of the leading preventable causes of stroke. The danger is that it often causes no symptoms at all until the moment it causes a stroke. The opportunity is that, when it's found in time, stroke can frequently be prevented.
Cardentey Vascular Care offers a complete stroke-prevention program built around the carotid arteries, including all three modern approaches to treating carotid narrowing. Dr. Cardentey, a board-certified vascular surgeon, is trained to perform each one, which means the treatment is chosen to fit the patient — not limited to whatever a given center happens to offer.
What is carotid artery disease?
Carotid artery disease is the buildup of plaque in the carotid arteries — the two large blood vessels on either side of your neck that carry blood to the brain. As plaque narrows the artery, it can restrict blood flow or break loose and travel to the brain, blocking a smaller vessel and causing a stroke. It is a major and often silent cause of ischemic stroke.
What are the warning signs?
Carotid artery disease frequently has no symptoms until a stroke or a "mini-stroke" (transient ischemic attack, or TIA) occurs. When warning signs do appear, they can include:
- Sudden numbness or weakness in the face, arm, or leg — especially on one side
- Sudden trouble speaking or understanding speech
- Sudden vision loss in one eye, often described as a curtain coming down
- Sudden dizziness, loss of balance, or a severe unexplained headache
A TIA causes these symptoms briefly and then they resolve — but a TIA is a serious warning that a major stroke may follow, and it should be evaluated urgently, not dismissed.
Stroke is a time-critical emergency.
Who is at risk for carotid artery disease?
The risk factors are largely the same as for other vascular disease, because it's the same underlying plaque process. Your risk is higher if you have high blood pressure, high cholesterol, diabetes, a history of smoking, are over 65, or have heart disease or peripheral artery disease. Because these conditions travel together, someone with PAD or coronary disease has good reason to have their carotid arteries checked.
How is carotid artery disease diagnosed?
Carotid artery disease is most often found with a quick, painless ultrasound of the neck (a carotid duplex scan) that measures blood flow and shows how much the artery has narrowed. If the ultrasound finds significant narrowing, more detailed imaging may be used to plan treatment. This is one reason a vascular evaluation is valuable for anyone with multiple risk factors — the screening itself is simple and non-invasive.
How is carotid artery disease treated?
Treatment depends on how narrowed the artery is and whether you've had symptoms. For many patients — particularly those with mild narrowing and no symptoms — the right treatment is best medical therapy: managing blood pressure and cholesterol, controlling diabetes, stopping tobacco, and taking the appropriate medications. For these patients, modern medical management alone has reduced the yearly stroke risk substantially.
When narrowing is severe, or when it has already caused symptoms, a procedure to clear or reopen the artery can dramatically lower the risk of stroke. There are three established ways to do this — and Dr. Cardentey performs all three.
The three approaches to treating a narrowed carotid artery
| Approach | What it is | Often a good fit for |
|---|---|---|
| Carotid endarterectomy (CEA) | The long-standing surgical standard. The surgeon opens the artery through a small neck incision and removes the plaque directly. | Many patients with significant narrowing; a durable, well-proven option. |
| TransCarotid Artery Revascularization (TCAR) | A newer, minimally invasive procedure that places a stent through a small incision at the base of the neck while temporarily reversing blood flow to protect the brain from debris. | Higher-risk patients and those whose anatomy makes the groin approach less ideal; avoids passing through the aortic arch. |
| Transfemoral carotid artery stenting (TF-CAS) | A stent placed in the carotid artery via a catheter inserted through the groin. | Selected patients for whom a catheter-based, no-neck-incision approach is preferred. |
Why does offering all three matter? Because the safest choice depends on your anatomy, your overall health, and whether you've had symptoms — and no single approach is best for everyone. TCAR in particular has been shown in large studies to carry a lower risk of stroke than the older groin-based stenting approach, while avoiding the aortic arch. A surgeon who performs all three can match the technique to the patient rather than fitting the patient to the one technique available.
Patient case
Carotid body tumor (Shamblin class 3)
A young patient with a Shamblin class 3 carotid body tumor treated with surgical excision. The tumor was adherent to the vagus nerve; final pathology revealed a schwannoma.
Why a stroke-prevention focus?
Because the entire point of treating carotid disease is to prevent a stroke before it happens. A stroke can permanently change a person's life in an instant. Finding and treating a narrowed carotid artery in time is one of the clearest examples in medicine of prevention being far better than the alternative. That's the purpose of this program: to identify carotid disease early and intervene at the right moment, with the right approach, to keep a stroke from ever occurring.
FAQ
Frequently asked questions
Yes. Carotid artery disease is one of the leading preventable causes of stroke. Plaque in the carotid arteries can restrict blood flow to the brain or break loose and block a vessel, causing a stroke. Finding and treating significant narrowing in time can substantially lower that risk.
Often it has none until a stroke or mini-stroke (TIA) occurs, which is what makes it dangerous. Some people first learn they have it during a screening ultrasound. Because it can be silent, people with risk factors like high blood pressure, diabetes, or a history of smoking benefit from evaluation.
TransCarotid Artery Revascularization (TCAR) is a minimally invasive procedure that places a stent in the carotid artery through a small incision at the base of the neck while temporarily reversing blood flow to protect the brain. Studies have associated it with a lower stroke risk than the older groin-based stenting approach.
There is no single best procedure for everyone. The right choice — carotid endarterectomy, TCAR, or transfemoral stenting — depends on your anatomy, your overall health, and whether you've had symptoms. A surgeon who performs all three can recommend the safest option for your specific situation.
Most often with a simple, painless ultrasound of the neck that measures blood flow and shows the degree of narrowing. It requires no needles or dye. If significant narrowing is found, more detailed imaging helps plan treatment.
Protect your brain before a stroke happens
If you have risk factors for vascular disease — high blood pressure, high cholesterol, diabetes, or a history of smoking — or if you've had any stroke-like warning sign, a carotid evaluation is a simple, painless first step.
Call our Largo office to schedule a carotid evaluation, or request an appointment online.
If you are experiencing stroke symptoms now, call 911 immediately.