Gorovitz & Borten, P.C.
Attorneys at Law

550 Cochituate Road, Suite 25
Framingham, Massachusetts
Tel: (781) 890-9095
Carotid Artery Stenosis
Among patients that suffer a stroke, extracranial carotid artery disease
represents the cause of approximately one half of cases. Hypertension,
coronary artery disease, peripheral arterial stenosis, obesity and diabetes are
associated with an increased incidence of carotid artery stenosis. Patients with
significant carotid artery stenosis are at an increased risk for stroke,
myocardial infarction (heart attack) and death.

If the degree of carotid artery stenosis is severe and there is no compensatory
collateral circulation, a portion of the brain becomes underperfused. A
diminution of cerebral blood flow increases the risk of thrombosis within the
cerebral circulation. Localized thrombosis may also occur in areas with pre-
existing atherosclerotic disease. Assessment of a patient who presents with
cerebral vascular disease should include evaluation of the patency of the
carotid arteries.

Carotid artery stenosis can be symptomatic or asymptomatic. In asymptomatic
patients, detection of a carotid bruit on physical examination requires further
assessment to rule out carotid artery stenosis. The increased risk of stroke is
greater in patients with symptomatic carotid artery stenosis but asymptomatic
carotid artery stenosis is also associated with an increased risk for stroke. In
some patients with hypertension and asymptomatic carotid artery stenosis,
attempts at lowering the blood pressure may trigger the appearance of
cerebral ischemic symptoms such as a transient ischemic attack (TIA).

Detecting carotid artery stenosis early and the use of surgery or endovascular
treatment can prevent a stroke from happening. Detection of carotid artery
stenosis include:

  • Physical examination
  • B-mode ultrasonography
  • Doppler ultrasonography
  • Transcranial Doppler Ultrasonography
  • CT angiography (CTA)
  • Magnetic resonance angiography (MRA)

Doppler ultrasonography is the primary noninvasive test for evaluation of
carotid artery stenosis. Measurement of the Peak Systolic Velocity, Peak End
Diastolic Velocity and Peak Systolic velocity ration  show good correlation with
the degree of carotid artery stenosis.

Mild to moderate carotid artery stenosis is amenable to medical treatment of
the underlying condition and the administration of oral medication. Reducing
the progression of the atherosclerotic disease and controlling hypertension
reduces the likelihood of progression to a more severe degree of arterial
stenosis. The administration of aspirin decreases the chances of platelet or
small clot formation with subsequent embolization. Severe carotid artery
stenosis greater than 70% may require carotid endarterectomy or stenting to
bypass the area of stenosis.

If you are suffering from complications due to a delayed diagnosis or failure to
treat  a carotid artery stenosis that caused you a stroke or the
mismanagement of a stroke, let
Dr. Borten review the specifics of your case.
At Gorovitz & Borten we have the necessary experience, understanding and
resources available to properly evaluate the complications of a stroke, and
give you a timely assessment of its merits.
Contact Information
For a free confidential consultation and receive a response within 24 hours
(when possible), please contact us by phone, fax or e-mail with your question
or concern.

Telephone:  781-890-9095     -     Fax:   781-890-9098
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