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Cardiolucent

Condition

Carotid artery disease

Conditions

Carotid artery disease is plaque accumulation in the large arteries on either side of the neck that supply the brain. As plaque grows, narrows the vessel, or becomes unstable, small fragments can break off and travel into the brain, causing a transient ischemic attack (TIA) or full stroke. Carotid disease is one of the most important treatable causes of stroke and frequently coexists with coronary and peripheral vascular disease — its presence is a marker of systemic atherosclerosis, not an isolated finding. Most patients have no symptoms until an event occurs, which is why selective screening, ongoing surveillance, and aggressive medical therapy form the core of management. Dr. Kedan coordinates carotid care with vascular surgery and neurology at Cedars-Sinai when intervention becomes appropriate.

What Cardiolucent Evaluates

  • Carotid duplex ultrasound with Doppler imaging to quantify stenosis and flow velocity
  • Serial surveillance imaging matched to stenosis severity and rate of change
  • Auscultation for carotid bruits during every visit
  • Whole-body cardiovascular risk assessment including coronary calcium when appropriate
  • Advanced lipid panel including LDL, ApoB, and Lp(a)
  • Blood pressure optimization with home and ambulatory monitoring
  • Coordination with vascular surgery and neurology at Cedars-Sinai for intervention decisions

Common Symptoms

  • Most patients have no symptoms until a TIA or stroke occurs
  • Sudden weakness or numbness on one side of the body — face, arm, or leg
  • Slurred speech or difficulty understanding language
  • Sudden vision loss in one eye (amaurosis fugax) — a classic warning sign
  • Sudden loss of balance or coordination
  • Severe headache without obvious cause in some cases
  • A carotid bruit (whooshing sound) heard on physical exam, sometimes the only clue
  • Any of the above neurologic symptoms is a 911 emergency, even if they resolve

Risk Factors

  • Long-standing hypertension
  • Tobacco use, current or past
  • Diabetes and insulin resistance
  • Elevated LDL cholesterol and lipoprotein(a)
  • Coronary artery disease or peripheral vascular disease (a marker of systemic atherosclerosis)
  • Family history of stroke or premature vascular disease
  • Age over 60, with male sex more affected at younger ages
  • Prior radiation therapy to the head or neck
  • Chronic kidney disease

How Cardiolucent Approaches Treatment

Dr. Kedan treats carotid disease as part of a unified vascular protection plan rather than an isolated neck-artery problem. Medical therapy is the foundation for nearly all patients — high-intensity statins to stabilize plaque, antiplatelet therapy when appropriate, optimal blood pressure control, tobacco cessation, and tight metabolic management. Surveillance imaging is scheduled based on stenosis severity and rate of change rather than a fixed interval, so that intervention decisions are timed correctly. When narrowing becomes severe or symptomatic, Dr. Kedan coordinates with vascular surgery and neurology at Cedars-Sinai for endarterectomy or carotid stenting. The concierge model ensures that follow-up is consistent and that medication adjustments do not slip through the cracks.

Common Questions

Frequently Asked Questions

What is carotid artery disease?
Carotid artery disease is plaque buildup in the large arteries on either side of the neck that supply blood to the brain. As that plaque grows or becomes unstable, small fragments can break off and travel into the brain, causing a stroke or transient ischemic attack (TIA). It is one of the most important treatable causes of stroke, which is why screening and surveillance matter.
Does carotid disease cause symptoms?
Most patients have no symptoms until a stroke or TIA occurs. Warning signs of a TIA include sudden weakness or numbness on one side of the body, slurred speech, vision loss, or loss of balance, and require an emergency room visit even if symptoms resolve. Any of these warrant a 911 call — a TIA is often the body's last warning before a major stroke.
How is carotid artery disease diagnosed?
The most common test is carotid duplex ultrasound, which uses Doppler imaging to measure both the narrowing and the flow within each artery. It is painless, non-invasive, and highly accurate. More detailed imaging such as CT or MR angiography is added when ultrasound suggests significant narrowing or when surgery is being considered.
Who should be screened?
Screening is most valuable in patients with significant cardiovascular risk factors — long-standing hypertension, smoking history, diabetes, known coronary artery disease, peripheral vascular disease, or a strong family history of stroke. Routine screening of low-risk patients is not generally recommended. Dr. Kedan tailors screening decisions to your individual profile rather than applying a one-size-fits-all rule.
How is carotid disease treated?
Medical therapy is the foundation for most patients and includes a statin, antiplatelet medication when appropriate, blood pressure control, and tobacco cessation. When narrowing is severe or symptomatic, Dr. Kedan coordinates referral for carotid endarterectomy or stenting. Either intervention is most effective when paired with continued risk-factor management afterward.
Can carotid plaque be reversed?
Existing plaque rarely disappears, but aggressive LDL lowering and blood pressure control can stabilize plaque and reduce the chance of stroke significantly. In some cases, modest regression is seen on follow-up imaging. The most important goal is to prevent the plaque from rupturing, regardless of whether it shrinks.
How often do I need follow-up imaging?
Patients with mild stenosis are typically reassessed every 1–2 years, while those with moderate stenosis or recent progression are reassessed every 6–12 months. The cadence is individualized based on the rate of change, symptoms, and overall risk profile. POCUS at the office allows for additional assessment when appropriate.
Will I need surgery?
Most patients never require surgery. Procedural intervention is reserved for severe stenosis, particularly when accompanied by stroke or TIA symptoms. Dr. Kedan coordinates closely with vascular and neurology specialists at Cedars-Sinai when this becomes a consideration, ensuring the decision reflects both your imaging and your overall health.
What can I do to lower my stroke risk?
The most powerful steps are stopping tobacco, controlling blood pressure and cholesterol, treating diabetes, exercising regularly, and maintaining a healthy weight. Adherence to prescribed antiplatelet and statin therapy is equally important. Schedule a consultation with Dr. Kedan to build a personalized stroke-prevention plan.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.