Common signs
- Often none — found on ultrasound or exam
- Brief episodes of weakness or numbness on one side
- Temporary loss of vision in one eye (“a shade coming down”)
- Sudden trouble speaking — even if it passes in minutes, it's an emergency
How I treat it
- Carotid ultrasound — in our office lab, with RPVI-certified interpretation
- Medical management — coordinated with your primary doctor and cardiologist when surgery isn't needed; surveillance ultrasounds to watch stable plaque
- TCAR (transcarotid artery revascularization) — a minimally invasive stenting approach that uses flow reversal to prevent debris from migrating to the brain during the procedure
- Carotid endarterectomy — the time-tested open operation to remove the plaque directly
Common questions
Does carotid narrowing always need surgery?
No. Many people are managed with medication, risk-factor control, and surveillance ultrasounds. Procedures are considered based on how severe the narrowing is and whether it has caused symptoms.
What is TCAR, and how is it different from carotid endarterectomy?
Carotid endarterectomy is the time-tested open operation to remove the plaque directly. TCAR is a minimally invasive stenting approach that uses flow reversal to prevent debris from migrating to the brain during the procedure. Which one fits depends on your anatomy and health.
Which symptoms are an emergency?
Sudden weakness or numbness on one side, trouble speaking, or temporary loss of vision in one eye. Call 911 — even if the symptoms pass within minutes.