Stroke is the fifth leading cause of death in the United States and a leading cause of long-term disability. Many strokes are preventable, especially those caused by carotid artery disease, a condition where plaque builds up in the neck arteries that supply blood to the brain.
What Is Carotid Artery Disease?
The carotid arteries are two large arteries running along each side of your neck. They deliver oxygen-rich blood to the brain. When plaque (a combination of cholesterol, calcium, and other substances) accumulates inside these arteries, it narrows the channel for blood flow and can become unstable.
An unstable plaque can rupture, forming a blood clot that travels to the brain and blocks a smaller artery. This is an ischemic stroke. Alternatively, plaque fragments can break off and cause the same result.
Risk Factors Common Among Long Island Residents
Carotid artery disease shares risk factors with heart disease and PAD. The most significant include high blood pressure (the single biggest modifiable risk factor), high cholesterol, smoking (current or past), diabetes, age over 55, family history of stroke or vascular disease, obesity and sedentary lifestyle, and atrial fibrillation.
Many Long Island adults in their 50s, 60s, and 70s carry several of these risk factors simultaneously, making carotid screening a valuable part of preventive care.
Warning Signs: TIA and Stroke
A transient ischemic attack (TIA) is a temporary stroke-like episode where symptoms resolve within minutes to hours. TIA symptoms include sudden numbness or weakness on one side of the face, arm, or leg, sudden confusion or trouble speaking, sudden vision loss in one eye (like a curtain dropping), sudden severe dizziness or trouble walking, and sudden severe headache with no known cause.
A TIA is a medical emergency and a warning sign. Roughly 10 to 15 percent of TIA patients have a full stroke within 90 days if the underlying cause is not treated. If you experience any of these symptoms, call 911 immediately, even if they resolve.
Screening and Diagnosis
Carotid duplex ultrasound is the standard screening test. It is painless, takes about 20 to 30 minutes, and uses sound waves to measure blood flow and estimate the degree of narrowing in each carotid artery. No needles, no contrast dye, no radiation.
At M&S Vascular in Great Neck, Dr. Amir Salem uses carotid ultrasound as part of vascular risk assessment. Screening may be recommended for patients with multiple vascular risk factors, known plaque found on prior imaging, prior TIA or stroke symptoms, PAD or coronary artery disease (since vascular disease tends to be systemic), and strong family history of stroke.
Prevention and Treatment
For mild to moderate carotid narrowing without symptoms, treatment focuses on aggressive risk factor management. This includes blood pressure medications, statin therapy for cholesterol, antiplatelet medications (aspirin or clopidogrel), diabetes management, smoking cessation, regular exercise, and periodic ultrasound surveillance to monitor plaque stability and progression.
For severe narrowing (typically 70 percent or more) or symptomatic disease, a procedural discussion may be appropriate. Carotid endarterectomy (surgical plaque removal) and carotid artery stenting are established options with strong evidence supporting their use in selected patients.
Vascular Prevention at M&S Great Neck
Carotid artery disease evaluation fits within a broader vascular prevention approach. Patients with PAD, diabetes, or heart disease often benefit from carotid screening as part of comprehensive vascular care. The M&S Great Neck office at 935 Northern Boulevard serves patients from across Nassau and Suffolk counties. Call (516) 960-1954 to discuss whether carotid screening is appropriate for you.