Carotid Ultrasound

A carotid artery ultrasound is a diagnostic procedure that uses high-frequency sound waves to generate images of the neck's internal carotid arteries, which supply oxygen-rich blood to the brain. A carotid artery ultrasound is used to evaluate a patient's risk of stroke or other cardiovascular complications by checking for artery-narrowing plaque buildup.

In general, candidates for carotid artery ultrasound are those who are at high risk for, or beginning to display the symptoms of, carotid artery disease. Candidates include those who have recently had a stroke or carotid artery surgery; have an abnormal sound in, or damage to the walls of, a carotid artery; or are suspected of having blood clots in a carotid artery. High-risk candidates for carotid artery disease include those who have been diagnosed with diabetes or high cholesterol, or have a family history of heart disease.

During the ultrasound procedure, the patient lies faceup on a table, and a doctor applies a cool gel to both sides of the neck, at each artery's location. A transducer is moved over the arteries to give off sound waves; the sound waves' echoes bounce off the artery walls and blood cells, and are converted into images by a computer. The images, usually in black and white, are then displayed on a computer screen. If a Doppler ultrasound is included in the test, the flow of blood through the arteries can be detected; blood flow is usually shown in color. A carotid artery ultrasound is performed in a doctor's office, and usually takes less than 30 minutes.

There are no risks associated with a carotid artery ultrasound, and patients can return to their regular activities immediately afterward. Results are discussed with the patient shortly after the ultrasound is completed.

Carotid Endarterectomy

Carotid endarterectomy is a surgical procedure performed to remove plaque buildup inside the carotid artery so that normal blood flow may be restored. This procedure is usually recommended for patients who have suffered from a transient ischemic attack (TIA) or stroke, and whose carotid arteries are at least 70 percent blocked.

After the patient has received general anesthesia, a carotid endarterectomy will begin with an incision made in the neck to expose the narrowed carotid artery. A shunt is put in place to direct blood flow away from the area being operated on. The surgeon opens the artery and removes the plaque, usually in one piece. A vein from the leg may be grafted onto the carotid artery in order to widen it. The shunt is removed and all incisions are closed. The carotid endarterectomy procedure usually takes two hours.

A hospital stay is usually required after a carotid endarterectomy. Day-to-day activities can be continued about a week after surgery, as long as they don't involve strenuous physical labor. Neck aches may last for about 2 weeks after surgery so it is important that the patient not to turn their head too fast during the recovery period.

As with any surgical procedure, there are risks associated with the carotid endarterectomy procedure. Some of these risks include a reaction to anesthesia, the development of blood clots, a heart attack, stroke, redevelopment of plaque buildup, infection and death.

High Cholesterol

Cholesterol is produced by the liver, the intestines and nearly all tissues in the body. Cholesterol is needed for the production of hormones, vitamin D and the bile necessary to digest the fats in food. Cholesterol also protects cell membranes from changes in temperature. While a certain amount of cholesterol is needed, too much cholesterol is unhealthy. An excessive amount of cholesterol can block blood flow in the arteries. This lack of blood flow can lead to a stroke. While there are no symptoms of high cholesterol, a simple blood test can provide patients with results. Cholesterol levels can be controlled or reduced with an active and healthy lifestyle. In some cases, medication may be necessary to control high levels of cholesterol.

Types Of Cholesterol

There are three different types of cholesterol. Different blood tests are performed to individually measure each type of cholesterol.

High-Density Lipoprotein

High-density lipoprotein (HDL) is the "good" cholesterol because elevated HDL levels may reduce the risks for heart disease or stroke. It is believed that HDL returns excess cholesterol to the liver for elimination from the body.

Low-Density Lipoprotein

Low-density lipoprotein (LDL) comprises the majority of the body's cholesterol. It is considered to be the "bad" cholesterol because it builds up in the walls of the arteries causing them to narrow, blocking blood flow and leading to heart disease or stroke.

Very-Low-Density Lipoprotein

Very-low-density lipoprotein (VLDL) is composed of cholesterol, triglycerides and proteins. VLDL contains the highest amount of triglycerides than any other lipoprotein and is considered to be a "bad" type of cholesterol.

A total cholesterol test measures all types of cholesterol in the blood and the results indicate whether the bad cholesterol levels are too high.

Risks For High Cholesterol

Risks for developing high cholesterol increase with age. People who are at a higher risk for developing high cholesterol include those who:

  • Smoke
  • Are obese
  • Have diabetes
  • Eat a poor diet, high in saturated fat
  • Have high blood pressure
  • Do not exercise regularly

People with a family history of high cholesterol and heart disease have a greater risk for developing high cholesterol.

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