Carotid Artery Disease
The carotid arteries lie on both sides of the neck and travel into
the skull, bringing blood to the brain. Cholesterol and calcium-laden
plaque can build up in these arteries, leading to obstruction of blood
flow to the brain. More importantly, pieces of these plaques can break
free, causing blockage of arteries within the brain, causing a stroke.
If a very tiny artery is blocked off, or if the plaque in this artery
dissolves, the symptoms may be temporary, known as a transient ischemic
attack, or TIA. 
Symptoms
can include numbness or tingling on one side of the face or arm or leg.
There can be associated weakness or paralysis on one side of the body
or face. Some patients have the sensation of a black curtain falling
over one eye, causing blindness. Sometimes victims lose the ability
to speak or slur their words. The surgical treatment for this condition
involves either local or general anesthesia. A small incision in the
neck is made, the plaque material is removed from the artery, leaving
a smooth, debris-free surface, and the incision in the artery is closed
with fine sutures. 
A recent development is the treatment of obstructed carotid arteries
with stents. The x-ray pictures show an arteriogram (x-ray dye study)
of carotid artery disease. The picture at the left shows an irregular
dye pattern in the carotid artery, indicating that there is a significant
blockage. The picture at right shows that same carotid artery after
deployment of a stent. Carotid stenting is a new procedure without long
term data showing how patients do over time. Additionally, the risk
of stroke during stent deployment is higher than with surgery, but may
be useful in certain high risk patients with favorable carotid anatomy.