Harvard Heart Letter

Treating narrowed arteries in the neck

The options include surgery, stenting, or medications. Which is right for you?

The buildup of fat, cholesterol and other deposits on artery walls can block the flow of oxygen-rich blood to organs and tissues throughout the body. When clogs develop in the coronary arteries, the result can be a heart attack. But when obstructions develop in the carotid arteries of the neck, the main hazard is brain attack (stroke). Plaque in a carotid artery can cause a stroke by blocking blood flow to part of the brain, or by breaking loose and completely blocking a smaller vessel in the brain. Symptoms of a pending stroke usually call for treatment to reduce the risk.

Endarterectomy versus carotid stenting

In endarterectomy (left), the artery is opened and the plaque removed. In carotid stenting (right), the plaque is pushed aside and the artery held
open with a stent.

Illustrations by Michael Linkinhoker and Scott Leighton

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