BACKGROUND: The carotid arteries, which supply the brain with blood, extend from the aorta in your chest to the brain. People who smoke, eat a diet high in saturated fat, or have conditions including diabetes, high blood pressure or high cholesterol are at risk for a potentially life-threatening condition called carotid artery disease, when the artery becomes blocked. Age also appears to be a risk factor, according to the Society for Vascular Surgery. While only 1 percent of adults aged 50 to 59 have significantly narrowed carotid arteries, 10 percent of those aged 80 to 89 have the problem. While the carotid artery is normally smooth and unobstructed, a sticky substance called plaque can build up to cause narrowing or blockage. Plaque is made of cholesterol, calcium and fibrous tissue.

SYMPTOMS: Unfortunately, the first symptom of carotid artery disease can be a stroke. What causes the stroke? If soft plaque deposits form irregular areas inside the artery, the body will treat the area as an injury, sending an excess of blood-clotting cells. A large blood clot then forms in the artery or one of its branches and blocks the artery, stopping blood and oxygen flow to the brain. A piece of the plaque itself or a clot can also cause a stroke by breaking off and traveling to the brain.

Before a stroke, patients with carotid artery disease may experience warning symptoms called transient ischemic attacks. During the attacks, which can last for a few minutes up to one hour, a person may feel weakness, numbness or tingling on one side of the body; lose control of arm or leg movement; lose vision in one eye; or lose the ability to speak clearly.

TREATMENT: New techniques allow surgeons to clear carotid arteries while the patient is awake. A newly published study out of Italy examined a technique called "cooperative patient general anesthesia." After the carotid artery was clamped, surgeons brought the patient out of general anesthesia and instead used a morphine-like drug called remifentanil that suppresses pain. While under the effects of the remifentanil, patients could carry out simple commands like opening their eyes and squeezing something in their hands. Having the patient awake allowed surgeons to verify that the brain received enough blood during the procedure. According to the study, 99 percent of patients found the experience non-stressful, sometimes even pleasant. Most described the experience as dreamlike, and none reported pain or distress.

FOR MORE INFORMATION, PLEASE CONTACT:
Leslie Capo
Public Relations
LSU Health Sciences Center
New Orleans, LA
(504) 568-4806