Treatments and drugsBy Mayo Clinic staff
The goal in treating carotid artery disease is preventing stroke. The method of treatment depends on how narrow your arteries have become.
Mild to moderate blockage
When you have mild to moderate blockage of your arteries, the following recommendations may be sufficient to prevent stroke:
- Make lifestyle changes. Healthy changes in your behavior can help reduce the stress on your arteries and slow the progression of atherosclerosis. Such changes include quitting smoking, losing weight, eating healthy foods, reducing the amount of salt you eat and exercising regularly.
- Manage chronic conditions. It's also key to manage any chronic conditions you have, such as high blood pressure, excess weight or diabetes. With your doctor, you can form a plan to specifically address these conditions by managing your blood pressure, maintaining a healthy weight, controlling your blood sugar levels and lowering your cholesterol.
- Use medications. Your doctor may ask you to take a daily aspirin or another blood-thinning medicine to avoid the formation of dangerous blood clots. He or she may also recommend medications to control your blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors or calcium channel blockers, or a statin medication to lower your cholesterol.
When you have severe blockage of your arteries — especially if you've already had a TIA or stroke related to the blockage — it's best to open up the artery and remove the blockage. There are two ways to do this:
- Carotid endarterectomy. This surgical procedure is the most common treatment for severe carotid artery disease. The procedure is done under either local or general anesthesia. After making an incision along the front of your neck, your surgeon opens the affected carotid artery and removes the plaques. The artery is repaired with either stitches or, preferably, a graft. Studies have also shown that the surgery is low risk in most otherwise healthy people, has lasting benefit and helps prevent strokes.
- Carotid angioplasty and stenting. A carotid endarterectomy isn't recommended when the location of the narrowing or blockage is too difficult for the surgeon to access directly or when you have other health conditions that make surgery too risky. In such cases, your doctor may recommend a procedure called carotid angioplasty and stenting. While you're under local anesthesia, a tiny balloon is threaded by catheter to the area where your carotid artery is clogged. The balloon is inflated to widen the artery, and a small wire mesh coil called a stent is inserted to keep the artery from narrowing again.
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