Peripheral Artery Disease Diagnosis
Peripheral artery disease is typically silent and does not present with symptoms. Physicians can screen patients based on risk factors like high blood pressure, diabetes, obesity and smoking. Sometimes, patients are screened for carotid artery disease if the doctor knows the patient has vascular disease elsewhere in the body. Blockages can also be found when a physician hears a sound through a stethoscope placed on the neck. The sound is caused by blood flowing past the blockage.

You should consider a vascular screening if you have any of the following risk factors:

• Age (50 years or older)
• Smoking
• High blood pressure
• Diabetes
• Obesity
• High cholesterol
• Family history for strokes, abdominal aortic disease and heart disease
• Prior heart attack, bypass operation or coronary stent

Traditional Treatment Options for Peripheral Artery Disease
Treatment options for carotid artery disease depend upon the severity of the overall patient condition and symptoms. Moderate disease may not require an interventional procedure, as some individuals can manage the disease with medications and lifestyle changes. More severe blockages may require surgery. Today, there are three primary surgical approaches:

• Carotid Endarterectomy (CEA): This open surgical procedure removes plaque from inside the carotid artery in order to restore normal blood flow to the brain. The surgeon makes an incision on the neck to access the affected artery, opens the artery and removes the plaque. The surgeon will then close the artery and the incision in the neck using stitches.


• Transfemoral Carotid Artery Stenting: In this minimally invasive alternative procedure, the physician works through a tube inserted into the artery in the upper thigh. First, a small umbrella-like filter is placed beyond the diseased area of the carotid artery to help limit fragments of plaque from traveling toward the brain during the procedure. The physician then inserts a slender, metal-mesh tube, called a stent, which expands inside the carotid artery to increase blood flow to the brain and stabilize the plaque.


• TransCarotid Artery Revascularization (TCAR): TransCarotid Artery Revascularization (TCAR) is an innovative technology developed to treat patients with carotid artery disease who are at risk for open surgery. The entire TCAR procedure is performed through a smaller incision in the neck and in less than half the time of a carotid endarterectomy - limiting the stress on the heart and significantly cutting the risk of the patient having a stroke or heart attack during the procedure. During the TCAR procedure, a tube inserted into the carotid artery is connected to a system temporarily directing blood flow away from the brain to protect against dangerous debris from reaching the brain and causing a stroke during the procedure. Surgeons filter the blood before returning it to a vein in the groin, and a stent is implanted to the carotid artery to stabilize plaque and prevent strokes.

Watch a brief video narrated by Dr. Brian Peterson about surgical options for the treatment of carotid artery disease.

Contact Us
To learn more or to schedule your vascular screenings at St. Luke's, please call 314-205-6074.

Sources:
https://vascular.org/patient-resources/vascular-conditions/carotid-artery-disease
https://www.cdc.gov/stroke/facts.htm
https://www.world-stroke.org/world-stroke-day-campaign/why-stroke-matters/learn-about-stroke
http://silkroadmed.com/disease-and-treatment-options