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Anyone who has a risk factor for atherosclerosis or hardening of the arteries. Anyone who has cardiac disease. A patient with hypertension, a patient with a history of smoking, a patient with diabetes: they are all risk factors for stroke. Anyone with these risk factors should be tested. Otherwise anyone over 65 should have one screening, perhaps once a year, and have it done so that the we know that the arteries are clean and we are all happy. Let's say there is a 50% block.

Spinal stenosis is a narrowing of the spinal canal. Some individuals are born with a lower than normal diameter of the spinal canal. Most individuals develop spinal stenosis with time. Just as the joints of the fingers become larger with age and wear and tear, the joints of the spine do as well. In the case of the spine, this enlargement of the facet joints and the intervertebral joints results in narrowing of the neural foramina and the spinal canal.

Carotid artery disease occurs when plaque builds up on the artery wall. This condition is called stenosis and is the leading cause of thrombolotic stroke. Early warning signs of stenosis can be detected by a primary care physician during a regular physical exam and include the presence of a carotid bruit or a difference in blood pressure in the right and left arms.

You may have either spinal stenosis or vascular disease. You first step should be to see either a spine surgeon or a vascular surgeon. Both spinal stenosis or vascular disease are correctable problems if properly diagnosed and treated. If you pain is due to vascular disease, medication can sometimes help. Surgically fixing the bad blood vessels can often completely correct a vascular problem.

Spinal stenosis can be treated initially by decreasing the inflammation and the swelling on the nerves so that they fit a little bit better in the space that is still available. When there is no response to conservative treatment, then surgical treatment may be required. Surgical treatment for spinal stenosis consists of removing the material that is producing the stenosis, such as bone spurs or pieces of bone from fractures. Spinal stenosis is a slowly progressive condition.

A carotid endarterectomy is a surgical procedure in which the carotid artery is exposed and plaque is removed, thereby reducing the risk of a thrombus breaking off and interrupting blood flow to the brain. Patients are often hospitalized for 48 hours after the procedure. Complication rates for carotid endarterectomy are approximately 3 percent.

The carotid arteries are the major vessels that supply blood to the head, moving up both sides of the neck to the brain and face. When blood flow to the brain is blocked, a serious medical condition called a stroke or brain attack can occur. The narrowing or blockage is often caused by a buildup of blood clots and fatty plaques (like cholesterol) in the fork of the carotid artery where it branches into the vessels that supply blood to the face and brain.

Two tests are available to CREST physicians to pinpoint exactly how much narrowing has occurred in your carotid artery: Ultrasound, or carotid Doppler uses sound waves to measure the rate of blood flow through the artery. (You may have already had this test.) Cerebral angiography uses a contrast material injected into an artery (usually in the groin) to make the vessels in the head and neck visible in x-rays. Pictures are then taken and the amount of narrowing is measured.

The Carotid Arteries are the major blood vessels supplying the head and brain. The external carotid supplies blood to the face, scalp and other external head tissues. The internal carotid supplies blood to the brain.

Carotid Stenting basically involves the same technique as for coronary angioplasty. Initially, we dilate the lesion with balloon angioplasty and then place a stent across the blockage. The whole procedure takes only half an hour to 45 minutes and the risks are considerably less than carotid surgery, even though carotid stenting is just evolving. Further refinement in equipment and technique greatly reduces the risks.

Several diagnostic tests can be used to determine a patient's degree of stenosis, including doppler ultrasound, MRI/MRA, and angiography. The determination of which test to use depends on the patients individual symptoms, risk factors and the services available in the patient's community. Doppler ultrasound is a basic, non-invasive imaging test that visualizes arteries in the neck by using sound waves to determine the flow of blood through the artery.

For patients with less than 50 percent stenosis, medical therapy is often prescribed. These treatments include anticoagulent drugs, like Warfin, and antiplatelet drugs, like aspirin, Ticlopidine and Plevix.. Patients with more than 50 percent stenosis often require a more aggressive approach including carotid endarterectomy and endovascular stenting.

Yes, our techniques work very well for spinal stenosis and other disorders that relate to nerves impinged by bone or disc. We can remove small amounts of disk and bone that are impinging upon the spinal cord. The removal of this bone and soft tissue is under direct observation to assure that the nerve impingement is resolved. You are awake during the procedure and can alert us to whether the problem is resolved or not.

Blood flow to the brain is restored CEA has been the standard of care for the treatment of carotid stenosis for the last four decades.