Carotid artery ultrasound: A probe placed against the skin reflects sound waves off the carotid artery, and a computer constructs images on a screen. Doppler ultrasound can be used to measure blood flow in the carotid artery, including any areas of narrowing, or stenosis.
Carotid artery angiography, known as an angiogram: Contrast dye is injected into blood vessels, and X-rays are taken of the neck, revealing images of the carotid arteries. A narrowing, or stenosis, and a bulging, or aneurysm, in the carotid artery may be detected by angiography.
Computed tomography angiography (CTA scan): A CT scanner takes multiple X-rays, and a computer compiles them into images of the carotid artery and other arteries of the neck and brain. Contrast dye injected into the blood vessels can help reveal more details of the carotid arteries, such as narrowing or bulging, aiding diagnosis.
Magnetic resonance angiography (MRA scan): An MRI scanner uses a high-powered magnet and a computer to create highly detailed images of the carotid artery and other arteries that supply the brain. MRA is superior to CT scanning in detecting strokes and most carotid artery problems.
Carotid sinus massage: In a controlled setting, a doctor massages the neck directly over the carotid sinus. This maneuver may unmask carotid sinus problems and can be used to treat certain abnormal heart rhythms.
Carotid Artery Treatments
Carotid endarterectomy: A surgery to open a narrowing, or stenosis, caused by cholesterol plaque in the carotid artery. A vascular surgeon cuts open the carotid artery, removes the plaque, and sews the artery closed.
Statins: Cholesterol-lowering medicines taken in pill form daily. Statins may reduce the risk of stroke and heart attack in some people with narrowing of the carotid artery, known as stenosis.
Aspirin: In people at high risk for heart attack or stroke, a daily aspirin may reduce the risk of a future stroke or heart attack. Aspirin works by interfering with the components of blood that help blood to clot, known as platelets.
Clopidogrel (Plavix): Clopidogrel may be used with or without aspirin in people at high risk for stroke or heart attack. Like aspirin, clopidogrel interferes with the components of blood that help blood to clot, known as platelets.
Carotid artery stenting: A wire is moved through an artery in the leg up to the carotid artery, and a small wire tube, or stent is expanded inside a narrowing of the carotid artery. Carotid artery stenting can be performed in people with carotid artery stenosis who are poor candidates for endarterectomy.