Carotid artery disease care at Mayo Clinic

A Mayo Clinic neurologist converses with a man about a possible carotid artery disease diagnosis. Carotid artery disease consultation

A Mayo Clinic neurologist talks with a man about his diagnosis and options for care.

Your Mayo Clinic care team

Mayo Clinic doctors collaborate on carotid artery disease care. Collaboration on carotid artery disease care

Mayo Clinic doctors work as a team to deliver the best possible care for carotid artery disease.

Mayo Clinic carotid artery disease care brings together neurologists and neurosurgeons as well as cardiologists, vascular and endovascular surgeons, and neuroradiologists, working together to provide complete diagnosis and treatment designed for you.

This diverse, specialized expertise focused on you means you benefit from the whole team's efforts to find the best approach for your condition. Mayo Clinic's team approach means health care providers can often provide diagnosis and develop a treatment plan within a few days.

Advanced diagnosis and treatment

Mayo Clinic doctors review carotid artery disease test results. Experience and expertise in carotid artery disease

Mayo Clinic doctors are deeply experienced in advanced diagnostic and treatment approaches for carotid artery disease.


Vivien Williams: Carotid artery disease increases your risk of stroke. Plaque builds up in the arteries in the neck, and if some breaks away, it could travel to your brain and cut off blood flow. But results of a study published in the New England Journal of Medicine give doctors the information they need to choose the best preventive procedures for their patients.

It's called the CREST Trial — Carotid Revascularization Endarterectomy versus Stent Trial. What that means is researchers tested open surgery versus stenting of the carotid artery to see which procedure was best at opening blockages and preventing stroke. Findings show that open surgery and stenting are equally safe and effective at preventing stroke, except for people over the age of 80.

Albert Hakaim, M.D.—Mayo Clinic vascular surgery: Based on the CREST Trial for patients who are older and the majority of vascular patients are older, carotid endarterectomy is superior to stentings.

Vivien Williams: Dr. Albert Hakaim says, people over 80 who have stents placed to open blockages in their carotid arteries have a higher risk of stroke after treatment than those who had the open operation. But if you're younger, both procedures are equally beneficial.

You see, blockages happen after years of plaque buildup on the artery walls. If a piece breaks off, it could flow to the brain and cut off blood supply, causing stroke. Here's a comparison of the two procedures.

First, the standard operation. With the patient under general anesthesia, Dr. Hakaim makes an incision in the neck to expose the carotid artery which carries blood to the face and brain. Then he inserts a temporary shunt to reroute blood so they can work on the artery. Next, he opens the artery lengthwise, removes plaque, and closes the incision.

Stenting is less invasive. With the patient having local anesthesia, Dr. Hakaim advances a catheter through the femoral artery in the leg up to the blockage. Just above it, he places a tiny umbrella shaped device to make sure that if the pieces of plaque break off they don't flow to the brain. Then he deploys the stent, which is pushed into place by a balloon. The stent opens the artery and crushes the plaque against the artery wall.

Albert Hakaim, M.D.: So here's the common carotid artery. And this is where the artery branches, so this branch goes to the face. This was the narrowing. This is the stent before the angioplasty.

Vivien Williams: Two procedures, both safe and effective at preventing stroke in the right groups of patients. The CREST Trial is important, because stroke is the third leading cause of death in the U.S. and the number one cause of disability. Now doctors can be more certain that the procedures they do for their patients will reduce the risk of stroke. For Medical Edge, I'm Vivien Williams.

Wide experience and skill in advanced stenting techniques

Treating blocked arteries presents many challenges. It calls for various tools and surgical procedures. Mayo Clinic surgeons are skilled at using the full range of advanced stenting technologies. This means Mayo surgeons can provide the best treatment for each person based on that person's medical needs.

Mayo Clinic doctors place stents for carotid artery disease. Advanced surgical technique

Mayo Clinic doctors are expert in advanced stenting techniques for carotid artery disease.

Expertise and rankings

Every year, Mayo Clinic specialists treat more than 5,300 people with carotid artery disease. This high volume means Mayo Clinic surgeons have a lot of experience doing complex procedures such as carotid endarterectomy and carotid angioplasty and stenting.

Mayo Clinic in Rochester, Minnesota, Mayo Clinic in Phoenix/Scottsdale, Arizona, and Mayo Clinic in Jacksonville, Florida, are ranked among the Best Hospitals for neurology and neurosurgery and for orthopedics by U.S. News & World Report. Mayo Clinic Children's Center in Rochester is ranked the No. 1 hospital in Minnesota, and the five-state region of Iowa, Minnesota, North Dakota, South Dakota and Wisconsin, according to U.S. News & World Report's 2023-2024 "Best Children's Hospitals" rankings.

Certified stroke centers

Mayo Clinic's campus in Florida was the first Joint Commission-certified Comprehensive Stroke Center in Florida by The Joint Commission, a national organization that evaluates and accredits health care providers. It's the only one in its region. Mayo Clinic's campus in Rochester, Minnesota, was certified as a Comprehensive Stroke Center in 2015. Mayo Clinic's campus in Arizona is certified as a Primary Stroke Center.

Locations, travel and lodging

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

For more information on visiting Mayo Clinic, choose your location below:

Costs and insurance

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.

More information about billing and insurance:

Mayo Clinic in Arizona, Florida and Minnesota

Mayo Clinic Health System

April 19, 2023


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