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Carotid Stenosis Treatment
The AGH Division of Vascular Surgery enjoys a close collaboration with the AGH Stroke Service. As a full-service provider of vascular surgery, surgeons in our division perform a wide variety of open and minimally invasive procedures. In the area of stroke prevention and treatment, we contribute primarily by performing procedures for carotid stenosis. Both carotid endarterectomy and carotid stenting are effective treatment options for carotid stenosis. Carotid endarterectomy is the traditional gold standard method of treating carotid disease. Carotid angioplasty and stenting is a new method that may be a better choice patients under specific circumstances. Our division offers both options, and we choose the procedure based on individual patient characteristics and patient preference.
About the AGH Vascular Surgery Division
Vascular disease strikes almost as many Americans as heart disease and cancer do. Yet many patients do not know what the term means. Quite simply, vascular disease refers to diseases of the blood vessels outside of the heart. Many different areas can be affected by vascular disease.
The surgeons in our Division provide comprehensive care for patients suffering from this complex disease and works to bring greater understanding and awareness to them and their families. One of the few of its kind in western Pennsylvania, the AGH Vascular Surgery Division is part of the AGH Cardiovascular Center, which includes not only vascular surgery, but also the Cardiac Surgery Center and the Advanced Wound Healing and Lympedema Center. The center brings together a team of physicians, nurses, physical therapists and other health-care professionals to diagnose and treat patients with vascular conditions. This center offers patients the most advanced treatment modalities available for the complete spectrum of vascular disease. Through our multi-disciplinary approach to diagnosis, therapeutic intervention and research, the program offers patients with vascular disease a one-stop shop for their clinical needs with a staff dedicated to providing astute, personalized care.
To contact the AGH Division of vascular surgery, please call, fax, email, or write us at:
320 E. North Avenue
14th floor, South Tower, AGH
Pittsburgh PA 15212
Vascular Surgeons at AGH
Satish Muluk, MD
Dr. Muluk has been the division director since May 2003. He trained at Massachusetts General Hospital.
Daniel Benckart, MD
Dr. Benckart practices cardiac and vascular surgery. He has been at AGH for over 20 years. He trained at Vanderbilt Hospital.
Dean Healy, MD
Dr. Healy has been with AGH for over 10 years. He trained at Vanderbilt Hospital.
Joseph Young, MD
Dr. Young practices both general and vascular surgery. He has been at AGH for over 20 years. He trained at the University of Pittsburgh.
Bart Chess, MD
Dr. Chess practices vascular surgery and trained at Ohio State University.
Conditions we treat
- Abdominal aortic aneurysm (AAA)
- Carotid artery stenosis
- Venous insufficiency and varicose veins
- Lower extremity arterial disease, Claudication, Gangrene
- Renal failure, dialysis access
- Thoracic and thoraco-abnominal aneurysm (TAA)
Atherosclerosis is most common in people over age 45. Smoking, high blood pressure, diabetes, family history of arterial disease, high cholesterol levels, sedentary lifestyle, and obesity can raise the risk of atherosclerosis.
- Brief loss of vision, for a few seconds to a few minutes, caused by the temporary blockage of small blood vessels in the eye. Sufferers experience a loss or dimming of vision in one eye only, described as a shade being pulled down or up.
- TIA (transient ischemic attacks): These are mini-strokes and involve a temporary interruption of blood flow in the brain. These attacks can bring temporary paralysis, weakness or numbness in the arms or legs and a loss of speech. They usually end within minutes and can last upto one hour. A TIA is considered a warning sign of a major stroke and should be evaluated urgently in the emergency room because of the short term risk of stroke. One out of 10 people (10 percent) who suffer a TIA may suffer a stroke within two days of the of the TIA.
- Stroke: Stroke occurs when too little blood flows to the brain. Cells in that area of the brain die, and can no longer control the related bodily function. The person affected by a stroke might be unable to walk or may experience memory loss.
It is important to understand that patients with significant carotid disease can feel normal until the time of a stroke, TIA, or brief loss of vision. In some instances, the surgeon will recommend surgery to prevent a stroke, even when the patient is feeling well.
Carotid duplex or ultrasound testing is very useful in diagnosing carotid disease. This noninvasive test uses sound waves to look inside the artery. If a blockage is found, your physician may order an angiogram, which will show the exact location and extent of the blockage.
When tests reveal that less than 70 percent of the artery is blocked, physicians usually recommend aspirin therapy, followed by a duplex study in six months. When blockages are above 70 percent, a surgeon may recommend carotid endarterectomy or carotid stenting to help prevent future strokes.
Patients who have narrowing of the carotid artery may reduce their risk of future strokes with this procedure. The surgeon makes an incision in the neck overlying the carotid artery — the major blood vessel bringing blood to the brain — and removes fatty deposits from the artery. The patient is usually discharged the day after surgery.
Learn more about carotid endarterectomy outcomes at AGH.
In some cases, carotid disease can be treated by placement of a stent in the blocked artery. This procedure is done via a catheter inserted into the groin, eliminating the need for an incision in the neck. Carotid stenting is a new procedure, but it holds promise for certain patients. Your physician can help you to decide whether stenting is appropriate in your particular case.
Key Facts About Carotid Endarterectomy
Carotid endarterectomy is a surgical procedure done through a small incision (four to six inches) in the neck to remove the blockage inside the carotid artery. This procedure is performed to reduce the risk of stroke.
Patients come to the hospital on the day of surgery. Surgery typically lasts for two hours, and over 90 percent of our carotid endarterectomy patients go home on the first day after surgery.